4316 Nicols Rd - COCCity of Etan
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE fol
INFLOW & INFILTRATION
City Sanitary Sewer Permit n City Plumbing Permit
City of kale
City of Eagan, Minnesota
Property Address: 1 43 t (n 1 C lS 0-8
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on - 1 , 201
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECIIVE WORK PERFORMED
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):
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, 'ootIntrusion Dip /Settlement in Pipe, Other; - D--a -S J I SS -C "
0' 11 a► !i . Q c 3 r C /
City Approved: L OA_ E l &L / \.r /1. T / 1 ( G(-C i
Print name Signature Date
Yellow Copy: City of Eagan (Parcel File) rev. 2 23 2010