4614 1_2 Penkwe Way - COCCity of Ek on
City of Eagan,, Minnesota
Property Address: ` � V� 1�V� f CL
COMPLIANCE MITI INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City per sonnel on , 2010
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AF TER 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):
City Sanitary Sewer Permit
City Approved: � W\
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
fl City Plumbing Permit
NOTE: Applicable only if box is checked: 1 (Based on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or inspections be perfor med to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
Signature Date
Yellow Copy: City of Eagan (Parcel File)
City of Eago
s V e
rev. 2.23 2010