4781 Beacon Hill Rd - COCCity of Eapll
City Sanitary Sewer Permit n City Plumbing Permit
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Yellow Copy: City of Eagan (Parcel F Ile)
4 !!! li City of Evan
City of Eagan, Minnesota
Property Address: -2� -C v � V
COMPLIANCE WITH INITIAL INSPECTION
his is to certify that the property listed above has been inspected by authorized City personnel on alej , 201_D
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORREC IIVE WORK PERF ORMED
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 satisfactor ily completing the required corrective r epair work under (check all that apply):
NOTE: Applicable only if box is checked.r aced on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections be perfonn ed to minimize a potential blockage due to:
Grease Build -up, Rootlnttusion, Dip /Settlement in Pipe, Other: t`C' V`Z Q-A-0-s- K., - - - Pt"
ov- l- ['J l I t i i
City Approved: --- t vvti �� -M1 T'"� / y,,,,,-
Print name Signature Date
rev 2. 23 2010