2079 Shale Lane - COCCity of Din
City Approved: \ vv,
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address:
COMPLIANCE WITH INITIAL INSPEC TION
us 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 AFTER CORRECTIVE WORK PERFORMED
l j 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 1 City Plumbing Permit
NOTE r 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 performed to minimize atential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other„ �f't �Q�� 0 4S i
( i �l3 /2-o t
Signature Date
Yellow Copy: City of Eagan (Parcel File)
City of Ekaa
rev. 2.23.2010