2140 Shale Lane - COCCity of Emil
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
11 City of Eagan
City of Eagan, Minnesota
Pt (poly Address: 1L () S ot" E_
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on 'S * , 201 0
and found to be in compliance with Section 3 40 of the City Code and no corr ective walk was required.
COMPLIANCE AFIER 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):
n City Sanitary Sewer Permit City Plumbing Permit
NOT 7 Applicable only if box is checked.: (Based on a review of the Sewer Service video inspection /report on file, it is
recommended that per r.tfling or future inspections he performed to minimize a potential blockage due to:
Grease Build -up, ' oot Intrusion D /Settlement in Pipe, Other: (..)(
City Approved: tr
Print name
White Copy: Property Owner
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
rev 2 23 2010