4763 Cypress Pt - COC4 City of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: /. 1 o �� Y ?C,
COMPLIANCE WITH INITIAL INSPEC LION
[?his is to certify that the property listed above has been inspected by authorized City personnel on a , 201_0
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
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):
C City Sanitary Sewer Permit i City Plumbing Permit
City of Eapll
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::
City Approved: t i Vv k
Print name
White Copy: Property Owner
Signature
Yellow Copy: City of Eagan {Parcel Fite)
Date
rev 2 23 2010