4184 Topaz Dr - COC41 City of Dan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
I1
4 City of Eapll
City of Eagan, Minnesota
Property Address: p Cc• , 'CI ti'
COMPLIANCE WITH INITIAL INSPECTION
F} —This is to certify that the property listed above has been inspected by authorized City personnel on I ` ``. , 201 (.)
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):
City Sanitary Sewer Permit fl 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 thatpe ': j icy ing or future inspections be performed to minimize a potential blockge due to
Grease build -up, ' +oot Intl usion, ip /Settlement in Pipe, Others L � H- �5
City Approved: - 73 Vet
Print name
White Copy: Property Owner
Signature Date
Yellow Copy: City of Eagan (Pace] File)
rev 2 . 23 2010
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