2081 Jade Lane - COC4 City of Eagan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: c E�
COMPLIANCE WI I H INITIAL INSPECTION
his is to certify that the property listed above has been inspected by authorized City personnel on , 2016
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECIIVE WORK PERFORMED
7 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):
fl City Sanitary Sewer Permit [ 1 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 per ormed to minimiz e a potential blockage dn, e (o:
Gr ase B ild -up, Root Intrusion, Dip /Settlement in Pipe, Other: C Vti.4_)Lil4 Y-��i-
S 1 i.t ` Oh D — Lfq CVO 1.6 0 uiL oc— to.:et. —Cc_ GQ
City Approved: 1 l -CJ \AieL04--ILC 1 2`N
Print name Signature Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
4 City of Eapn
rev 2 23 2010