4271 Jasper Dr - COC4 , 11 ' City of Ekan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Ikvi City of Eagan
City of Eagan, Minnesota
Property Address: `�� +( 0 Ii
COMPLIANCE WITH INITIAL INSPEC I ION
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
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):
NOTE: Applicable only if box is checked. ased on a review of the Sewer Service video inspection /report an file, it is
recommended that s ning or future inspections be performed to minimize a potential blockage due to
Grease Build - r, Root Intrusion, ►,, Settlement in Pipe, Other: • i CJ : �5 a ‘
City Approved:
Print name
White Copy: Property Owner
n City Sanitary Sewer Permit I City Plumbing Permit
Date
Signature
Yellow Copy: City of Eagan (Parcel F ile)
rev. 2 23 2010