811 Wescott Square - COCCity of Eaftal
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
111 City of Eapa
City of Eagan, Minnesota
Prop erty Address: S I \ CCs` LLB.
COMPLIANCE WIIH INI IIAL INSPEC IION
This is to certify that the property listed above has been inspected by authorized City personnel on — t l , 201_®
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required.
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
Q 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 7 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 that periodic cleaning of future inspections beperfonn ed to minimize a potential blockage due for
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other: VOCY l i cy 'Kb
et_ vvLe4_
Print name
City Approved:
White Copy: Property Owner
Signature Date
Yellow Copy: City of Eagan (Parcel File)
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rev 2 23 2010