2116 Shale Lane - COCCity of Ear
City Approved: ' \t>
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Ea as
City of Eagan, Minnesota
Property Address: {��� L(Jk Yl
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on -��'� 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
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:Based on a review of the Sewer Service video inspection /report on file, it is
recommended that ing or future inspections be performed to minimize a potential blockage due to:
Grease Build- ,,, Root In trusion ip /Settlement in Pipe, Other: 14 - -
\ 6 .4st-01 - i)
'J Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev 2 23.2010