4495 Clover Lane B - COCCity of E a�all
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
PropertyAddress: It q q (6) Cf0 L'^
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on vG /3 , 201L
and found to be in compliance with Section .3 40 of the City Code and no corrective work was r equired
COMPLIANCE AFTER COItRECIIVE 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 repair work under (check all that apply):
n City Sanitary Sewer Permit 1 City Plumbing Permit
City Approved: J$4ES r
Print name Signature
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel Pile)
City of Evan
NOTE Applicable only if box is checked: QBased 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:
rev 2 23.2010