4080 Nicols Rd - COCCity of EaRai
City Approved: �J 1� v� V.
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
- C� Z ` �1 i Co kS e() Property Address:
COMPLIANCE WITH INIIIAL INSPECTION
Ihis is to certify that the property listed above has been inspected by authorized City personnel on S-1 9. , 2010
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
U 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 7 City Plumbing Permit
NOTE, Applicable only if box is checked: sed on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic ning or future inspections be performed to najnimize a potential blockage due
Grease Build- u}CRoot Intrusion, ip /Settlement in Pipe, Other.: 1 -S k+ 5 C OSS' 101 '
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
City of Eaiall
rev. 2 23.2010