826 Ivy Lane - COCCity of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eapn
City of Eagan, Minnesota
Property Address:
COMPLIANCE WITH INITIAL INSPECTION
his is to certify that the property listed above has been inspected by authorized City personnel on C " , 2010
and found to be in compliance with Section 3 40 of the City Code and no carrective work was required
COMPLIANCE AFIER CORRECTIVE WORK PERFORMED
fl 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 r epair work under (check all that apply):
City Approved:
pi City Sanitary Sewer Permit
NOTE:. Applicable only if box is checked: 'Based 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 potential blockage due to
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
Print name
White Copy: Property Owner
City Numbing Permit
Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev 2 23 2010