4653 Kingsbury Dr - COC4 City of Eapa
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Paoperty Address: ��� L v k.t .�
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COMPLIANCE WITH INITIAL INSPEC IION
This 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 required.
COMPLIANCE AF IER CORREC TIVE 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):
n City Sanitary Sewer Permit n City Plumbing Permit
NOTE Applicable only if box is checked :1 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.;
•
l
City Approved: /
Print name L Signature
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
Date
dek City of kali
ll �5C.� D - t 6
rev 2.23 2010