2127 Shale Lane - COCCity of Eaftall
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Print name Signature
Date
City of Eagan, Minnesota
Property Address: D- 1 - D-" - 1 5 koi -e _. c vv - --e::.
COMPLIANCE WIIH INITIAL INSPECTION
his is to certify that the property listed above has been inspected by authorized City personnel on r5 , 201 0
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 ❑ City Plumbing Permit
City of Eapa
NOTE: Applicable only if box is checkec}Based on a review of the Sewer Service video inspection /report on file, it is
recommended that perk"' _ _. • i ning or future inspections be performed to minimize a potential blockage due to:
Grease Build -up, ' i of lntrusio , Dip /Settlement in Pipe, Other: S Tr= ! - , Sc — k::+
/ 9 \ Ve -ec-i-e_6-io r■ — k - - )- - 3- 5 t .----7- i —
City Approved: v 1>L. / 1 ` 1 &O / ! a' -/ t D
Yellow Copy: City of Eagan (Parcel Fife) rev 2 23 2010