4618 Summit Pass - COCCity of Ea ail
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Cafall
City of Eagan, Minnesota
Property Address: L i ( % S \.),A AY�i
COMPLIANCE WITH INIIIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on t F � 201_0
and found to be in compliance with Section 3 40 of the City Code and no corrective work was r equired
COMPLIANCE AFTER CORRECTIVE 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):
7 City Sanitary Sewer Permit City PIumbing Permit
City Approved: `v%
Print name
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.:
White Copy: Property Owner
/
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
- DO] 0
rev 2 .23 2010