4485 Clover Lane - COCCity of Eagan
City Approved: J/4714E3
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: C to v
COMPLIANCE WITH INITIAL INSPECTION
Ihis is to certify that the property listed above has been inspected by authorized City personnel on 66 ft - Z, 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
n 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 required corrective r epair work under (check all that apply):
n City Sanitary Sewer Permit City Plumbing Per
NODE: 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 to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
k 7
Signature Date
City of Eaaall
Yellow Copy: City of Eagan (Parcel File) rev 2 23.2010