2096 Shale Lane - COCCity of Eta]
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on ~~t'" 01 , 201_0
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
n 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 n City Plumbing Permit
NOTE: Applicable only if box is checked: used on a review of the Sewer Service video inspection /report on file, it is
recommended that per iodic cleaning or future inspections be performed to minimize a potential blockage due to:
Grease Build -up, oot Intrusio Dip /Settlement in Pipe, Other: k ^ .
City Approved: 1 VLF -V� / 41/S—
jl -t,t�� -�"J / 1 �l a0 7 �
Print name Signature Date
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: { o S6:1 X CI irk
City of Eapo
Yellow Copy: City of Eagan (Parcel F ile) rev 2.2.3 2010