2034 Jade Lane - COCCity of Faiaa
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eaaall
City of Eagan, Minnesota
Property Address: -
COMPLIANCE WITH INIIIAL INSPEC IION
his is to certify that the property listed above has been inspected by authorized City personnel cn , 201
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
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):
C City Sanitary Sewer Permit n City Plumbing Permit
NOTE, Applicable only if box is checked„ teased on a review of the Sewer Service video inspection /report on file, it is
recommended that perio.. ' aning or future inspections he performed to minimize a potential blockage due to:
Grease Build -u ;, ' oot Intrusion I ip /Settlement in Pipe, Other:
�E' c OK
S & 1P ,
City Approved: 1 vvt
Print name
White Copy: Property Owner
r\ ( S-. I .ti f mo t
Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev 2232090