2062 Diffley Rd - COCCity of Eaftall
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: D-CJ(o
COMPLIANCE WIIH INITIAL INSPECIION
This 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 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 r epair work under (check all that apply):
n City Sanitary Sewer Permit n 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 thatpe ' rng or future inspections be performed to minimize a otential blockage due to:
Grease Build -up, oot Intrusion, ip /Settlement in Pipe, Other: I F ", 6, Lk
City Approved: 1 OA-
Print name
White Copy: Property Owner
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
City of Eag,an
rev 2 2 , 2010