856 Ivy Lane - COCCity of Eagan, Minnesota
Property Address:
COMPLIANCE WIIH INITIAL INSPEC LION
i i
City of Iapll
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
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This is to certify that the property listed above has been inspected by authorized City personnel on , 201
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
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 - 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 tend (blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other: S. a c-,6
City Approved:
Signature
Print name
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
Date
City of Eag,all
rev 2.23 2010