2089 Jade Lane - COCCity of hp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eapn
City of Eagan, Minnesota
Property Address: 3-0 TSB
COMPLIANCE WITH INITIAL INSPEC TION
Ihis is to certify that the property listed above has been inspected by authorized City personnel on lv , 2010
and found to be in compliance with Section .3 .40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
_
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):
Lj City Sanitary Sewer Permit fl City Plumbing Permit
NOTE: Applicable only if box is checked: Teased 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:
City Approved: 1 yv\ YAr' 1` ( / t 1 /' 1 �J
Print name Signature Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File) rev 2 23 2010