1606 Sherwood Way - COCCity of Car
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
COMPLIANCE WITH INITIAL INSPECTION
City of Eagan, Minnesota
4 ,_y- ,��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 correctiv e work was required
COMPLIANCE AFTER CORRECIIVE 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):
City Sanitary Sewer Permit 1 City Plumbing Permit
NOTEr 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: \ 1 TILLS I \46U-kik iJ I �b
Print name v Signature Date
Yellow Copy: City of Eagan (Parcel File)
City of Eapu
rev 2.23.2010