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2875 Lexington Ave - Septic Maintenance Form 2018-08-17fiity ofEagan ilot Knob Road MN 55122 I Phon6: (651)675-5675 Fax: (651)675-5694 Email: commclevetopmentlocitvofeaqan.com SEPTIC SYSTEM MAINTENANCE FORM Owners Address (if ditrerent from site)l #orrankspumped @ Z rotarGa,onspumped: l&0 PtP* Ettueni sewase D scharse Yes sro/r o*-J7 khlonf| LicenseNumbe. Z7g1 l/v^ kltqtu^rype ofTanks. (..n l(n Uv^ Please submit compteted forms to th6 Building tnspections Oivision via mait,Iax or ehail. I L- __-