2073 Jade Lane - COCCity of Eapll
City Approved:
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: D3`T
Yellow Copy: City of Eagan (Parcel File)
City of Eaaall
COMPLIANCE WITH INITIAL INSPEC TION
'his is to certify that the property listed above has been inspected by authorized City personnel on / . 201 C�
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECIIVE 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):
j I City Sanitary Sewer Permit City Plumbing Permit
NOTE: 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 beperforn:ed to minimize a potential blockage due to:
Grease Build -up, oot Intrusion Dip ettlentent in Pipe, Other: la- . a , X 7 3 - s X5 3 s q 3 � q
Print name Signature Date
rev 2 23 2010