1484 Thomas Lane - COCCity of E . ail
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Pr'oper'ty Address:
City Approved: �
Print name
City of Eagan, Mirmesota
1 1 - 4
COMPLIANCE WITH INITIAL INSPECTION
T his is to certify that the property listed above has been inspected by authorized City personnel on
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel F ile)
41 City of BaiaIl
/27 , 201
and found to be in compliance with Section 3 40 of the City Code and no corrective work was r equired.
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
fl 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 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 be performed to minimize a potential blockage due to
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other.'
.1-4 rs 6
Signature Date
rev. 2 23 2010