4770 Beacon Hill Rd - COCCity of Evan
SANITARY SEWER. SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Etali
City of Eagan, Minnesota 1
Property Address: � 1:1 O - toti_J 1r. ' \ 1 1 11 2_0
COMPLIANCE WIIII INIIIAL INSPEC TION
This is to certify that the property listed above has been inspected by authorized City personnel on } " , 201 0
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
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 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 periodic cleaning or future inspections be perfor . ed to i mize a pote tial blockag due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other.: V ti _ �" '�� `�.'l a h 3 -
City Approved:
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Signature Date
Print name
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
rev. 2.23 2010