3723 South Hills Way - COCCity of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: }` SCL. \ t\ t cc_y
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on [ , 201 Li
and found to be in compliance with Section 3 40 of the City Code and no corrective work was r equired.
COMPLIANCE AF TER CORREC TIVE WORK PERFORMED
fl 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):
1 1 City Sanitary Sewer Permit 1 1 City Plumbing Permit
City Approved: ' Wt ■„.
Print name
White Copy: Property Owner
4 City of all
NOTE: Applicable only if box is checked: LjBased on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections beperformed to minimize apotential blockage due to
Grease Build -up, Root intrusion, Dip /Settlement in Pipe, Other
Signature
Yellow Copy: City of Eagan (Parcel F ile)
Date
rev 2 23 2010