844 Ivy Lane - COC4 City of Emil
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE far
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: Uf' 1I-.J "
COMPLIANCE WITH INITIAL INSPECTION
Ihis is to certify that the property listed above has been inspected by authorized City personnel on , 2010
and f to be in compliance with Section 3.40 of the City Code and no corrective work was required.
COMPLIANCE Al TER CORREC TIVE WORK PERt ORMED
n 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
NOTE: Applicable only if box is checked: used on a review of the Sewer Service video inspection /report on file, it is
recommended thatperiodic cleaning or future inspections be perforimed to minimize apoten al blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Othe MU(' , 14 � � ,3
City Approved: 1 VV� �1 I tr1,-- 1 t l 1r} )<1)
Print name Signature Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
411 City of Evan
rev 2 23 2010