4605 1_2 Penkwe Way - COCCity of Eao.II
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of E .g
City of Fagan, Minnesota
Property Address: (off a- Re-AAACitaf,.._ W aof
COMPLIANCE WIIH INIIIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on - D- < , 201
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required.
COMPLIANCE AF TER CORREC TIVE 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):
n City Sanitary Sewer Permit n City Plumbing Permit
.NOTE, Applicable only if box is checked„ Based 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: kAeku -4V\ I � / / ( "/2 6-0 1 0
Date
White Copy: Property Owner
Print name Signature
Yellow Copy: City of Eagan (Parcel File)
rev 2.23 2010