1465 Thomas Lane - COC4 City of Eagan
City Approved:
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Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: � � ZG iXICs S CL v1
COMPLIANCE WIIH INITIAL INSPECTION
a This is to certify that the property listed above has been inspected by authorized City personnel on
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):
n City Sanitary Sewer Permit n 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:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other;'
R fiLA 1L
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
City of Eapil
-1 4;2016
rev 2,