4765 Beacon Hill Rd - COCCity of Eapll
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eat .il
City of Eagan, Minnesota
Property Address: 1- r1 cb' C1-L(5 i 4 l\ 2.o G-4
COMPLIANCE WITH INITIAL INSPEC TION
This is to certify that the property listed above has been inspected by authorized City personnel on k , 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
n 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
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 beperfo med to minimize a potential blockage due to.
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other: va vv\A3 -se..6) p ; / KO
r'.
City Approved:
White Copy: Property Owner
Print name
n City Plumbing Permit
•• ��• 1 gt o t p-G !
Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev 2.23 2010