1438 Wellington Way - COCd e li ` City of Evan
White Copy: Property Ownei
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
COMPLIANCE WITH INITIAL INSPECTION i
X Ihis is to certify that the property listed above has been inspected by authorized City personnel on L . � , 201 tn
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
� J,f
City Approved: l tom,
Print name
City of Eagan, Minnesota
I / ? e,,l ,
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 I City Plumbing Permit
NOTE: Applicable only if box is checked : URased 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:
Signature
Yellow Copy: City of Eagan (Parcel F ile)
Date
A City of EapIl
LU
rev 2 23.2010