3973 Pumice Lane - COCCity of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: "3913 u, (C' 6
COMPLIANCE WITH INITIAL INSPECTION
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' This is to certify that the property listed above has been inspected by authorized City personnel on t ), ot , 201 1
'and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
n This is to certify that the property listed above has been found to be in compliance with Section 3 40 of the City Code
after satisfactorily completing the required corrective repair work under (check all that apply):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked, ❑Rased on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections be performed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved:
j F f((rr
9
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Print name i Signature Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
City of Evan
rev 2. 2010