4376 Nicols Rd - COCCity of &go
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
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City of Eapll
COMPLIANCE WITH INITIAL INSPECTION
....,This is to certify that the property listed above has been inspected by authorized City personnel on 1, � , 201_Q
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AF CORRECTIVE WORK PERFORMED
Ihis 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 In 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
r ecommended that , # ' aning or future inspections be performed to minimize a potential blockage due to
Grease Build- ,f, Root Intrusion Dip /Settlement in Pipe, Other ' ,, , -T . °SF'f' s `Z 5
City Approved: r�
Print name
White Copy: Property Owner
) 'ea 'D-oi
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
rev. 2 23 2010