1425 Rebecca Lane - COCCity of hp
City of Fagan, Minnesota
Property Addy ess: '5
COMPLIANCE WITH INITIAL INSPECTION
phis is to certify that the property listed above has been inspected by authorized City personnel on 3 0, 201 a
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
n 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):
City Sanitary Sewer Permit fl City Plumbing Permit
NOTE, Applicable only if box is checked: IBased 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:
City Approved:
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
City of Earful
rev 2.23.2010