4750 Beacon Hill Rd - COCIli' City of Eapll
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota 4 {�
Property Address: 4'1 6 -eo-co %A. l t Eo G,e
COMPLIANCE WITH INITIAL INSPECTION
A This is to certify that the property listed above has been inspected by authorized City personnel on
and found to he in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
17 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 requited corrective repair work under (check all that apply):
n City Sanitary Sewer Permit 1 ( City Plumbing Permit
City Approved: t
Print name
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
City of hp
0 --C:
NOTE: Applicable only if box is checked: ased 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:
w� I� 1T 1 ` 30 4).6 t u
Signature Date
, 2010
rev 2