4140 Nicols Rd - COCSANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eapll
City of Ea aI
City of Eagan, Minnesota
Property Address: I 40 \ i Cc t S t `J
COMPLIANCE WIIII INITIAL INSPEC IION
- his is to certify that the property listed above has been inspected by authorized City personnel on J — [ , 2010
and found to be in compliance with Section 3 .40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORREC IIVE 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):
fl City Sanitaty Sewer Permit n City Plumbing Permit
NOTE :. Applicable only if box is checked: Based on a review of the Sewer ° Service video inspection /report onfrle, it is
recommended that periodic cleaning or future inspections be performed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved: J 1 UN"- \ �`
Print name
White Copy: Property Owner
Signature
V izu-1/4±Li - / :lC (P/-
Yellow Copy: City of Eagan (Parcel File)
Date
rev. 2.23.2010