4657 Beacon Hill Rd - COC41 10 I City of Eapo
City Approved: v'v• LAL
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Property Address: 6 — e_C -CCU k CeC
C OMPLIANCE WITH INITIAL INSPECTION
Ff —Ihis is to certify that the property listed above has been inspected by authorized City personnel on - , 201
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AF TER CORREC TIVE 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):
n City Sanitary Sewer Permit 1 City Plumbing Permit
1 , 11 ` City of EapIl
NOM.. 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,
f) l � i / U / CS i 0
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
rev 2 23.2010