4711 Hazeltine Lane - COCCity of Eagan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, ` Minnesota
Property Address: 7 II 1'tG� i--e 4 H L u'
COMPLIANCE WITH INITIAL INSPECT ION
This is to certify that the property listed above has been inspected by authorized City personnel on
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
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., 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:
White Copy: Property Owner
City Approved: vv. ,1,1;s.,44 / \A js... �. i� 1 / I �- 3-010
Print name U Signature Date
Yellow Copy: City of Eagan (Parcel P ile)
City of IaftaI
-I 9 201 6
rev 2. 23 2010