2017 Bluestone Lane - COCCity of Flap
City Approved:
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Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of hp
City of Eagan, Minnesota
Property Address: 1 2) k `es v 1-e LC).
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on 1-7 , 2016
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required.
COMPLIANCE AFTER CORRECTIVE WORK PERFORIVIED
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 City Plumbing Perrnit
NOTE: Applicable only if box is checkeded 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: A + y\ V L. ( °� i P " VI
S J Q;, O €c o w.S T LETS P+ 1‘ c_ 1
\- -- l - E / 19 h-6 16
Signature Date
Yellow Copy: City of Eagan (Parcel File) rev. 2.23, 2090