4610 Penkwe Way - COCCity of Cagan
City Approved: t'L 'tl`
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERI`IFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
City of h
City of Eagan, Minnesota
Property Address: * ( 0 Vev3kiO-Q. 6 ---
COMPLIANCE WITH INIIIAL INSPEC ZION
�• This is to certify that the property listed above has been inspected by authorized City personnel on — , 2010
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):
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 -u;, 'oot Intrusion, Di /Settlement in Pipe, Other: '"4 r4-
V\-emak _ , �� - lam 1 0
rev 2.23.