1515 Thomas Lane - COC111 City of Evan
City Approved:
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
COMPLIANCE WITH INIIIAL INSPECTION
Ihis is to certify that the property listed above has been inspected by authorized City personnel on 1 6" , 201
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
7 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 fl City Plumbing Permit
/5
NOTE: Applicable only if box is checked l Based on a r eview of the Server Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections be performed to minimize apotential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other:
4 a,„1--P,
City of Eaiall
/ 21/51/
Signature Date
Yellow Copy: City of Eagan (Parcel File) rev 2 23 2010