4631 1_2 Penkwe Way - COCCity of hp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
'f (DJf '. l�_ r � l-2 adii
City of Iapii
COMPLIANCE WITH INITIAL INSPECTION /1�
K . Ihis is to certify that the property listed above has been inspected by authorized City personnel on 'I 7 , 201
and found to be in compliance with Section .3 40 of the City Code and no corrective work was required
COMPLIANCE AF IER CORRECTIVE 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 _ City Plumbing Permit
NOTE: Applicable only if box is checked: UBased 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, DipiSettlement in Pipe, Other:
City Approved: Ji m UHL/ / 41 1/0 1
Print name Signature Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
rev. 2,23.2010