2054 Jade Lane - COCCity of E
City of Eagan, Minnesota
Proper Address: � C f (t W1
COMPLIANCE WITH INITIAL INSPECTION
his is to certify that the property listed above has been inspected by authorized City personnel on 5 (, , 201
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
7 This is to certify that the property Iisted 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 Plumbing Permit
City Approved: — � ��
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Signature Date
Yellow Copy: City of Eagan (Parcel File)
City of Eat
NOTE Applicable only if box is checked Based on a review of the Sewer Service video inspection /report on file, it is
recommended that p re- caning or future inspections be performed to minimize a potential blockage due to:
Grease Build -up, oat lntrusi , Dip /Settlement in Pipe, Other„ _ t--'" 7 . -F
rev 2.23.2010