2095 Shale Lane - COCCity of kakali
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Iap,aR
City of Eagan, Minnesota
Property Address: D-O Q 5 J - e_
COMPLIANCE %VIIH INIIIAL INSPECTION
Ihis is to certify that the property listed above has been inspected by authorized City personnel on Co , 2010
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECTIVE CORK 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):
J
City Sanitary Sewer Permit I j City Plumbing Permit
NOTE: Applicable only if box is checked: !I 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 of ntial blockage due to:
Grease Build -up, Root intrusion, Dip /Settlement in Pipe, Other; 3\ , G
City Approved: 1 VM ,L -L I \A 1Z0 1
Print name Signature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
rev, 2 23 2010