4254 Jasper Dr - COCCity of mail
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Addr ess: -- p'ey Y V
City of kali
COMPLIANCE WITH INITIAL INSPECTION
~ .,.This is to certify that the property listed above has been inspected by authorized City personnel on , 201 0
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required.
COMPLIANCE AFTER CORREC TIVE 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):
❑ City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box• is checked: Based on a review of the Sewer Service video inspectiotheport on file, it is
recommended that pe 'z die F ping or future inspections be performed to minimize a potential blockage due to:
Grease Build -up, oot Intrusio .Dip /Settlement in Pipe, Other: C.C) -S r 3 _S Pr
City Approved: 7- A vv.
Print name
White Copy: Property Owner
/ of
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
rev. 2 23.2010