1416 Rebecca Lane - COC41 , 1 ‘ City of Evan
City of'Eagan, Mi esota
Property Address: { �,/(x2
COMPLIANCE WIT INITIAL INSPECTION
g jhis 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 corr ective work was r equired
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
I
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):
City Sanitary Sewer Permit 1 City Plumbing Permit
NOTE.: Applicable only if box is checked: Based on a review of the Server 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:
City Approved:
Print name
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Signature
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel File)
City of EaQaIl
/ ` � (sa
Date { {{
rev 2.23. 2010