830 Ivy Lane - COCCity of Ea u&
City Approved: ` + C 1,_
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: '
COMPLIANCE WITH INITIAL INSPEC LION
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 TER CORREC HVE WORK PERFORMED
El 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 ❑ City Plumbing Permit
NOTE: Applicable only if box is checked :'sed 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 potenpiflblockw due to:
Grease Build -up, R ntr usi 1 Dip /Settlement in Pipe, Other,: 1(00 �� S / 2 `£ co (� n
-'� �13S .
7I Cb/ G / 1
Signature
Date
City of hp
Yellow Copy: City of Eagan (Parcel File) rev 2.23 2010