4730 Walden Dr - COCpity of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Ea an, Minnesota
n
Property Address: 1A-1r } v e
COMPLIANCE WITH INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on/
and found to be in compliance with Section 3 40 of the City Code and no conecth e work was required.
COMPLIANCE AP TER CORRECTIVE WORK PERFORMED
1
E
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 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: t"'t
Print name
White Copy: Property Owner
Yellow Copy: City of Eagan (Parcel File)
/ 12_j
Date
City of Etall
, 201
rev 2 23 2090