4854 Richard Lane - COC1
City of EaRall
City of Eagan, Minnes to
f L
Ptoper tyAddress: " /� � vt-e
COMPLIANCE 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 corrective work was required
COMPLIANCE AF TER CORRECTIVE WORK PERFORMED
Ihis 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):
n City Sanitary Sewer Permit City Plumbing Petrnit
NOTE: .Applicable only if box is checked: nBased 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 apotential blockage due to:
Grease Build - -up, Root Intrusion, Dip /Settlement in Pipe, Other:.
City Approved:
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Print name Signature Date
Yellow Copy: City of Eagan (Parcel Fite)
41 City of EakaIl
, 201_ 0
rev 2. 23 2010