2110 Jade Lane - COCCity ofEapa
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: a\ 0 J `e- V
City ofEagaa
COMPLIANCE WITH INIIIAL INSPECIION
.This is to certify that the property listed above has been inspected by authorized City personnel on , 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
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 tha ^iodic-c ing or future inspections be performed to minimize a potential blockage due to:
Grease Build -u: ► ► .. .: ettlement in Pipe, Other, ', �5 5-�
City Approved: \� At- `. � .. / / ( Id -- -9.1 `-CD 1 L�
White Copy: Property Owner
Print name Signature
Yellow Copy: City of Eagan (Parcel File)
Date
rev 2 23 2010