1351 St Andrew Blvd - COC4 City of Eqpt
City Approved:
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota }J
.3 5 1 S il -trIJKv-k-L) Property Address:
COMPLIANCE WITH INITIAL INSPECIION
This is to certify that the property listed above has been inspected by authorized City personnel on 1 / , 201
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 PERF ORMED
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 corr ective repair work under (check all that apply):
n City Sanitary Sewer Permit 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 that periodic cleaning or future inspections beperformed to minimize a potential blockage due to.
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
r .
Signature
Yellow Copy: City of Eagan (Parcel File)
/ 1
Date
1 City of Eataa
rev. 2 23 2010