1891 Deer Hills Tr - COC4 City of EaRall
City Approved: Jek-mE
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota yam
Property Address: t Set/ Dee r to / -
) S (i- 1
COMPLIANCE WIT II INITIAL INSPECTION
r . This is to certify that the property listed above has been inspected by authorized City personnel on 6fzS , 201 i
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
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):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked;• rlBased 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:
/
r Date
Signa .re
Yellow Copy: City of Eagan (Parcel File)
41, City of Eagan
7
rev 2.23 2010