2094 Jade Lane - COCCity of Eago
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City Approved: / `?� /i � '` /1J / l / ( U
Print name � Signature Date
City of Eaaao
City of Eagan, Minnesota
Property Address: �{� L A - J N —�
COMPLIANCE WITH INITIAL INSPEC HON
` 7 Ihis is to certify that the property listed above has been inspected by authorized City personnel on J — , 201 (�
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AF IER CORREC TIVE 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: Based on a review of the Sewer Service video inspection /report on file, 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:
Yellow Copy: City of Eagan (Parcel File) rev 2 23 2010