4721 Westminster Cir - COCCOMPLIANCE WITH INITIAL INSPECIION
1 1
City of Emil
City Approved: GJ 4 'i.' r t�L
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE fot
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: iff , f'�1f `'°" r t`
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Signature ' Date
City of Eapil
This is to certify that the property listed above has been inspected by authorized City personnel on , 201
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORRECTIVE WORK PERFORMED
r
ra'fi is to certify that the property listed above has been found to be in'corpliance with Section 3 40 of the City Code
after satisfactorily completing the required corrective re work under (check all that apply):
City Sanitary Sewer Permit % City Plumbing Permit
NOTE: Applicable only if box is checked: UBased 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 Buildup, Root Intrusion, Dip /Settlement in Pipe, Other.:
Yellow Copy: City of Eagan (Parcel File) rev 2 .23 2010