903 Wild Rose Ct - COC4 City of hp'
I
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of hap
City of Eagan, Minnesota r'
Property Address: P_aS .A
COMPLIANCE WIIH INITIAL INSPECTION
R r—This is to certify that the property listed above has been inspected by authorized City personnel on , 20 1 [J
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AP TER CORRECTIVE WORK PERIORMED
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):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked: USused 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: � �(� \ AC-0.1.x, k-
Print name
White Copy: Property Owner
tJ Signature Date
Yellow Copy: City of Eagan (Parcel rile) rev 2 23 2010