868 Wescott Square - COCA lba City of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Proper ty Address:` S CC3 ti n `e-
COMPLIANCE WITH INITIAL INSPECTION
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 corr ective work was required
COMPLIANCE AF TER CORRECIIVE WORK PERFORMED
A City of 6apn
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 n City Plumbing Permit
White Copy: Property Owner
NOTE: Applicable only if box is checked, l (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, Root Intrusion, Dip /Settlement in Pipe, Other:
Print name Signature Date
City Approved:
Yellow Copy: City of Eagan (Parcel F ile) rev 2.23 2010