1379 St Andrew Blvd - COCCity of EaRall
City Approved: ")
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
13
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on /2 "/ ' 201 6
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required.
COMPLIANCE AFTER CORRECIIVE 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):
City Sanitary Sewer Permit n 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:
Print name
1z/ice/lc
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
4 City of Eagan
ivl
rev 2 23 2010