4635 Penkwe Way - COCCity of Din
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of hp
City of Eagan, Minnesota
Property Address: Yo 1/4 U`kl,0*
COMPLIANCE WITH INIIIAL INSPEC TION
� 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
L_I 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 n City Plumbing Permit
NOTE: Applicable only if box is checked: i 'Based on a review of the Sewer Service video inspection /report on, file, it A
recommended that periodic cleaning or future inspections be performed to minimize a potential blockage due for
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved: t Vvt_ get Lk
Print name
White Copy: Property Owner
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
rev 2 23.2010