4281 Jasper Dr - COCCity of•Bagan, Minnesota
Property Address: \/
COMPLIANCE WITH INITIAL INSPECTION
is is to certify that the property listed above has been inspected by authorized City personnel on C , 201
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORREC TIVE WORK PERFORMED
n 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 satisfactorily completing the required corrective repair work under (check all that apply):
City of Evan
City Approved:
n City Sanitary Sewer Permit
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE foi
INFLOW & INFILTRATION
n City Plumbing Permit
Yellow Copy: City of Eagan (Parcel F ile)
City of Eago
NOTES Applicable only if box is checked: `° $ased 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 otential blockage due to:
Grease wild- , Root Intrusl on ip /Settlement in Pipe, Other: - i 4 4 -5 { 7 7) ,
\\ 1 CO "o‘ / al v \ �i -ek-ti' -- / t 1 1
Print name Signature Date
rev. 2 23 2010