4053 Beryl Rd - COCCity of hp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
41 City of Evan
City of Eagan, Minnesota
Property Address: e' - 6 6 -€
COMPLIANCE WITH INITIAL INSPECTION
is to certify that the property listed above has been inspected by authorized City personnel on , 201 C
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required.
COMPLIANCE AF IER CORREC IIVE 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):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE, Applicable only if box is checked.: ased on a review of the Sewer Service video inspection/report on file, it is
recommended that pert aning or future inspections be performed to minimize a potential blockage due to:
Grease Build --u oot Intrusio , Dip /Settlement in Pipe, Other: 14 ,
City Approved: / LTA r /
Print name yvv_ S ignature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel F ile)
o /
rev 2.23 2010