2084 Shale Lane - COC4 City of EtipIl
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: 0.- --'
COMPLIANCE WIIH INITIAL INSPECTION
W illis is to certify that the property listed above has been inspected by authorized City personnel on Z "a , 201 C�
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
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 required corrective repair work under (check all that apply):
City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked: H; aced on a review of the Sewer Service video inspection/report on file, it is
recommended that peril' . _ . 'ailing or future inspections be performed to minimize a potential blockage due to;
Grease Build -up, oot Intrusion. Dip /Settlement in Pipe, Other.:
City Approved: v
Print name
White Copy: Property Owner
Signature Date
Yellow Copy: City of Eagan (Parcel File)
411 City of Evan
rev 2 23.2010