2140 Jade Pt - COCCity of hp
NOTE,: Applicable
recommended that
Grease Build -up 00
M i wt.& 6
City Approved:
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
Qo v
r City Sanitary Sewer Permit City Plumbing Permit
City of Eagan
COMPLIANCE WIIH INITIAL INSPEC LION
-ris is to certify that the property listed above has been inspected by authorized City personnel on , 201_0
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
Ihis 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):
only if box is checked, Based on a review of the Sewer Service video inspection /report on file, it is
er�iodic ping or future inspections be performed to minimize « otential blockage due to:
t Intrusio .Dip /Settlement in Pipe, Other: 4 .., L* 9 f t 3
1 4 - 1 p co� e - CCRD ~ 16 -I t
Print name Signature Date
OALICR
Yellow Copy: City of Eagan (Parcel F ile) rev 2.23.2070