704 Stonewood Rd - COCCity of Eapll
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: i 04 , 1- e ti3C3O O o
COMPLIANCE WIIH INITIAL INSPEC LION
This is to certify that the property listed above has been inspected by authorized City personnel on , 201 0
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORREC TIVE WORK PERFORMED
7 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
41 City of Evan
NOTE: Applicable only if box is checked: I IBased 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, Root Intrusion, Dip /Settlement in Pipe, Other:
City Approved: Vvt V $('i, �,� � �,`�,.�
Print name Signature Date
Yellow Copy: City of Pagan (Parcel File) rev 2 23.2010