850 Ivy Lane - COCCity of hp
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
COMPLIANCE WITH INI IIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on 41' , 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):
-City Sanitary Sewer Permit fl City Plumbing Permit
White Copy: Property Owner
City Approved: \ !� ei, it k\ / �� �^ \ — (-�
Print name V Signature
Yellow Copy: City of Eagan (Parcel F ile)
Date
4 City of EaRaff
NOTE,: Applicable only if box is checked: '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:
/D,61
rev 2.2.3.2010