2106 Quartz Lane - COCCity of Eapll
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan
City of Eagan, Minnesota
Property Address: �l l� �, Li(Y \'Z IN�
COMPLIANCE WIITI INITIAL INSPECTION
#1- This is to certify that the property listed above has been inspected by authorized City personnel on , 201 0
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AI 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):
C
City Sanitary Sewer Permit
City Approved:
NOTE: Applicable only if box is checked :1 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:
Print name
White Copy: Property Owner
City Plumbing Per
‘'keLL,,±ki
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
D-O l o
rev. 223 2090