1520 Thomas Lane - COC4111 !!"' City of Egli
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City Sanitary Sewer Permit
fl City Plumbing Permit
41 City of Evan
City of Eagan, Minnesota
COIVIPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on
and found to be in compliance with Section 3 40 of the City Code and no collective work was required
COMPLIANCE AF IER CORRECTIVE WORK PERFORMED
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 (c heck all that apply):
NOTE r Applicable only if box is checked: UBaced on a review of the Sewer Service video inspection /report on file, it is
recommended that per iodic 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 Signature Date
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
1 2-7/ct e.:7 -
rev. 2 23.2010