4653 Penkwe Way - COCCity of Eapll
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: Il i (S P`e k Liot
Print name Signature
Yellow Copy: City of Eagan (Parcel File)
COMPLIANCE WITH INITIAL INSPECIION
This is to certify that the property listed above has been inspected by authorized City personnel on - 3
City of Expo
, 201(
and found to be in compliance with Section 3 .40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORREC IIVE WORK PERFORMED
E 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):
H City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is .checked: nBased 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:.
City Approved -.. I /ar 1
Date
rev 2 2.3, 2010