4423 Clover Lane - COC41 City of Evan
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City Approved: �, A' CS
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: t4 Li 2 Clou er Lk
COMPLIANCE WITH INIIIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on 06 lZ , 2011
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
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 n City Plumbing Permit
NOT:' Applicable only if box is checked: nBased on a r eview 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:
4 City of Evan
Signature Date
Yellow Copy: City of Eagan (Parcel File) rev 2.23 2010