3868 Dolomite Dr - COC1]
City of Eapil
City Approved: jk4.4e -
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
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Pr operty Adcir•ess: 3 D �� C.A. C
COMPLIANCE WIIH INITIAL INSPECTION
X This is to certify that the property listed above has been inspected by authorized City personnel on , 201L
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
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 requited corrective repair work under (check all that apply):
Fl City Sanitary Sewer Permit 1 ; City Plumbing Permit
NOTE: Applicable only if box is checked: (Based on a review of the Sewer Service video inspection /report on file, it is
recommended that per iodic cleaning or future inspections be performed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other;
Print name
City of Eagan, Minnesota
Signat - re
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
5
Date
41 City of Evan
rev 2 23 2010