1360 Interlachen Dr - COC4 1*. City of Eapa
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel an / / , 201 C.n
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
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):
E City Sanitary Sewer Permit ❑ City Plumbing Permit
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:
City Approved:
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Pt op et ty Addr ess: C)
Print name f Signature
4 City of EapIl
1
Date
Yellow Copy: City of Eagan (Parcel F ile) rev 2.23 2010