4875 Windsor Ct - COCCity of hp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: L AI S l V C'_S0 t (_G 1.L.li
COMPLIANCE WITH INITIAL INSPECTION
Ft 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 corrective work was required
COMPLIANCE AF TER CORRECTIVE WORK PERFORMED
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 ;,sed on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections be perforrited to minimize a potential blockage due to:
Grease Build --up, Root intrusion, Dip /Settlement in Pipe, Other: T I\___ 110—L. p_st v„
City Approved:
Print name
White Copy: Property Owner
Signature Date
Yellow Copy: City of Eagan (Parcel File)
City of Eagall
rev. 2. 2010