4375 Rahn Rd - COCC! y of Evan
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: $ � kAr GLa
COMPLIANCE WITH INIIIAL INSPECTION
Ihis is to certify that the property listed above has been inspected by authorized City personnel on , 201
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required.
COMPLIANCE AF TER 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):
City Sanitary Sewer Permit
City Plumbing Permit
NOTE: Applicable only if box is checked.: used on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections beperformed to minimize a potential blockage due to
Grease Build -up rr u Dip /Settlement in Pipe, Other,' L.O "
City Approved: 1 V�rti I may- �Ct -t��, (7Z / sig 1-6
Print name Signature Date
City of Etat
Yellow Copy: City of Eagan (Parcel File) rev. 2 23.2010