1374 St Andrew Blvd - COC4 City of Eapn
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
Pro er Address: rY
P ty
City of Eapll
COMPLIANCE WITH INIIIAL INSPECTION
(mis is to certify that the property listed above has been inspected by authorized City personnel on la!? , 20i 0
, 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 r epair work under (check all that apply):
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City Sanitary Sewer Permit 1 City Plumbing Permit
NOTE:: Applicable only if box is checked:' uBased 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: '
Print name
White Copy: Property Owner
/ 2 -
Signature
Yellow Copy: City of Eagan (Parcel File)
Date
rev 2 23 2010
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