4879 Richard Lane - COCCity of Eot .11
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eakali
City of Eagan, Minnesota
Property Address: "[% � i [ y-J,
COMPLIANCE WIIH INITIAL INSPEC ZION
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 AE TER CORRECTIVE WORK PERFORMED
n 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):
City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked: used on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections be performed to mi imize a pot ntial block ge due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other,: S& J ( V % U -€ - -e Oh - l 1
City Approved: 1 w. C u 1 - V e L 1 , . J / / l / - - C ) Y Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
rev. 2 2.3. 2010
