4647 Kingsbury Dr - COCCity of k ali
City of Eagan, Minnesota
PiopextyAddiess: L / L {7
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
COMPLIANCE WIT H INI TIAL INSPECT ION
Ibis is to certify that the property listed above has been inspected by authorized City personnel on L , 201 .0
and found to be in compliance with Section 3.40 of the City Code and no Corr ective work was requited
COMPLIANCE At 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_ (check all that apply):
City Sanitary Sewer Permit n City Plumbing Permit
White Copy: Property Owner
NOSE: Applicable only if bo.x is checked:1 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:
City Approved: 1 " t ' ^ I
Print name
Signature Date
l
411 City of Eagan
Yellow Copy: City of Eagan (Parcel File) rev 2 23, 2010