4781 London Lane - COCCity of Ea all
COMPLIANCE WIIH INITIAL INSPECIION
City Approved:
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of ( Eagan, Minnesota
Property Address: L[ â 78 â ) L âLJ (3r/1
Ihis is to certify that the property listed above has been inspected by authorized City personnel on l 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
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):
Ti City Sanitary Sewer Permit City Plumbing Permit
NOTE: Applicable only if box is checked: nBased on a review of the Sewer Service video inspection /report on file, it is
I ecommended 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:
Print name Signature
Yellow Copy: City of Eagan (Parcel File)
L
I I
Date
411 City of Evan
rev 2 23 2010