2094 Copper Lane - COCCity of hp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
41 City of hp
City of Fagan, Minnesota
Property Address: '4-09 14 0.0. LCt
COMPLIANCE WITH INITIAL INSPECTION
0 This 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 AFTER CORRECTIVE WORK PERFORMED
n 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 r equired corrective repair work under (check all that apply):
n City Sanitary Sewer Permit p 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 that periodic cleaning or future inspections be performed to minimize a potential blockage due to
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other.
City Approved: 1 +1V. \ �,>- f� / Wei-0 /
Print name `+ Signature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
rev. 2 23.2010