1474 Thomas Lane - COCCity of Eagi
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of nn
f- L 1 Eagan, Minnesota '
Property Address: f `7 ! i 01 t tit) ire U
COMPLIANCE WIIII INITIAL INSPECTION
g This is to certify that the property listed above has been inspected by authorized City personnel on `► , 201D
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
El 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 1 City Plumbing Permit
NOTE: Applicable only if box is checked.: USased 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: J
White Copy: Property Owner
Print name
ign¢ture
Yellow Copy: City of Eagan (Parcel File)
1/47/01 6
Date
City of ERR
rev 2.23 2010