4041 Mica Tr - COCCity of Eapll
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City Approved: ) f ET5- I �".� ,' iV
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: Uri I I C) ` 1 '(-
COMPLIANCE WIIH INIIIAL INSPEC TION
Ibis is to certify that the property listed above has been inspected by authorized City personnel on
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECITYE 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
City Sanrtary Sewer.Permit 1 City Plumbing Permit
after satisfactorily completing the requited collective repair work under (check all that apply):
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 Build -up, Root Intrusion, Dip /Settlement in Pipe, Other
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Signature r ( Date
Yellow Copy: City of Eagan (Parcel File)
City of hp
, 201_
rev 2.232010 •