4649 Summit Pass - COCCity of Evan
CO f PLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on / , 201 CD
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required.
COMPLIANCE AF I ER CORREC TIVE WORK PERFORMED
n 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):
NOTE;' Applicable only if box is checked, uBased on a review of the Sewer Service video inspection /report on file, it is
r ecommended that periodic cleaning Of future inspections be performed to minimize a potential blockage due to:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other
City Approved:
City of Eagan, Minnesota
C
P; aperty Address: 1 io 4 1
n City Sanitary Sewer Permit 1 1 City Plumbing Permit
t-� 1 f ! ' C✓ C �- I
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Signature
Yellow Copy: City of Eagan (Parcel File)
i /2-
Date
l5
City of Eapll
rev 2.23 2010