4695 Nicols Rd - COCCity of hp
City Approved:' Cc3
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE foi
INFLOW & INFILTRATION
City of Eagan, Minnesota
Pr operty Adth ess: 4404 5 /k (LP 14 ® ( R
COMPLIANCE WIIIT INI TIAL INSPECITON
n This is to certify that the property listed above has been inspected by authorized City personnel on , 201_
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AF IER CORRECTIVE 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
after satisfactor ily completing the required corrective repair work under (check all that apply):
fl City Sanitary Sewer Permit Vrity Plumbing Permit
NOTE: 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:
id—f-f i> (11 (
Print name Signature Date
Yellow Copy: City of Eagan (Parcel File)
City of Eapll
rev. 2. 23 2010