4711 Beacon Hill Rd - COCCity of Eapll
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
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Property Address: � E � \ 1J -e-C',. v LG i-�.
41 City of bp
COMPLIANCE WITH INITIAL INSPECTION
his is to certify that the property listed above has been inspected by authorized City personnel on ( ° j s 2011
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required.
COMPLIANCE AF TER CORRECTIVE WORK PERFORMED
it 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):
1 City Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked, (JBased 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:
ti
City Approved: %\, \ kkij / I 230/ -C t CJ
Print name U Signature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File) rev 2 23 2010