1481 Wellington Way - COC4 City of Evan
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
I ? IeA l
City of Ewa
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on f 3 , 201 [�
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AFIERCORRECI'VE WORK PERFORMED
fl 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 n City Plumbing Permit
NOTE: Applicable only if box is checked. nBased 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: e? tJ /-cam f Z 1 410
Print name Signature Date
Yellow Copy: City of Eagan (Parcel File)
rev 2 23.2010