4064 Nicols Rd - COC41 City of Eat ll
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
4 City of Eagan
City of Eagan, Minnesota [�
Property Address: 46 (o 4 ( (.C) 1 S
COMPLIANCE WIIH INITIAL INSPECIION
is is to certify that the property listed above has been inspected by authorized City personnel on , 20l
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
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):
City Sanitary Sewer Permit
Print name
White Copy: Property Owner
City Approved:
n City Plumbing Permit
NOTE: Applicable only if box is checked„ 1 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:
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
rev 2 23 2010