1868 Gold Tr - COCCity of Et an
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SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Fagan, Minnesota
Pr operty Address: \
l r _.
COMPLIANCE WIIH INITIAL INSPECTION
n Ihis 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 CORREC IIVE WORK PERFORMED
Ihis 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):
City Sanitary Sewer Permit Hi City Plumbing Permit
City of Etall
NOn Applicable only if box is checked: ased 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: / - r, it '
."✓ J -)C t ,i! 1,01 ,L-17)/{)-7/1
/ Print n ame ' Signature Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel. F ile)
rev. 2.23 2090