4702 Penkwe Way - COCCity of Ea as
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
1 , 111 '' City of Eagan
City of Eagan, Minnesota
Property Address: L '7
COMPLIANCE WITH INITIAL INSPECTION
.his is to certify that the property listed above has been inspected by authorized City personnel on , 201_0
and found to be in compliance with Section 3 40 of the City Code and no corrective work was r equired.
COMPLIANCE AF IER CORREC IIVE WORK PERFORMED
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):
City Sanitary Sewer Permit 1 { City Plumbing 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:
Gr'ease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other
City Approved: l\N 48- / t f - I (D
Print name J � Signature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File) rev. 2 23. 2010