4279 Moonstone Dr - COCIJ
City of hp
City Approved: -∎\
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eapli
City of Eagan, Minnesota
Property Address: & "� c���{ iYk-izio\ - vve_
COMPLIANCE WIIII INITIAL INSPEC HON
his 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 AFTER CORRECTIVE WORK PERFORMED
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):
C City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked.: ased on a review of the Sewer Service video inspection /report on file, it is
recommended that per ping or future inspections be performed to minimize a otential blockage due to„
Grease Build- p, ' oot Intrusion Dip/Settlement in Pipe, Other: "44 1 'D -
Std -c_ - 6 A -
`v Signature
Yellow Copy: City of Eagan (Parcel File)
/ 06-616
Date
rev. 2 23.2010