2099 Shale Lane - COCCity of Ea on
COMPLIANCE WIIH INITIAL INSPECTION
City Apptoved: Cw
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: D-C2) C S A
NOTE: Applicable only if box is checked.:'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 oot Intru is on i /Settlement in Pipe, Other: D
Ihis is to certify that the property listed above has been inspected by authorized City personnel on �
and found to be in compliance with Section 3.40 of the City Code and no corrective work was requited
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 repair work under (check all that apply):
n City Sanitary Sewer Permit E City Plumbing Permit
Print name
I l 31 I D
Signature Date
Yellow Copy: City of Eagan (Parcel File)
City of Eapll
,2016
rev. 2.23 2010