2033 Bluestone Lane - CO
110, SANI'T'ARY SEWER SYSTEM
City of Ealan CERTIFICATE OF COMPLIANCE foi City of Eap
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address:
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above bas 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
COMPLUNCE 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):
City Sanitary Sewer Permit ❑ City Plumbing Permit
NOTE Applicable only if box is eheckedr ❑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:
City Approved: 1 VSN lei t~ \ 1 1 + I
Print name Signature Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File) rev 2.23 2010
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