3812 Country Creek Way - COCCity of Eaftall
City Approved? ,,
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
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Property Address: n i p '' ;� sl
COMPLIANCE WITH INIIIAL INSPECIION �Q v�TfY W ��
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 AFTER CORRECTIVE WORK PERFORMED
1- Ihis is to certify that the property listed above has been found to be in compliance with Section 3.40 of the City Code
J after satisfactorily completing the required collective repair: work under (check all that apply):
n City Sanitary Sewer Permit ill 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 periodic cleaning or future inspections be performed to minimize a potential blockage due for
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other.:
Signature
Yellow Copy: City of Eagan (Parcel File)
I
Date
City of Eagan
rev 2 23 2010