1390 St Andrew Blvd - COC1111 City of Eapn
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
4 City of Evan
City of' Eagan, Minnesota
Property Address: J� 0 _ OVl C V \ fit
COMPLIANCE WITH INITIAL INSPECTION
--This is to certify that the property listed above has been inspected by authorized City personnel on 1 CS - i , 201
and found to be in compliance with Section 3.40 of the City Code and no corr ective work was required
COMPLIANCE AFTER 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 1 j City Plumbing Permit
City Approved: r
Print name
White Copy: Property Owner
NOTE: Applicable only if box is checked:1 Based on a r eview 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:.
Signature
Date
Yellow Copy: City of Eagan (Parcel F ile) rev 2 23 2010