4731 Hazeltine Lane - COC41 City of Evan
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Property Address:
City of Eagan, Minnesota
COMPLIANCE WII II INITIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on 1 �! 2 , 201
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required.
COMPLIANCE AF I ER 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 repair work under (check all that apply):
City Approved: ZT ` I&
Print name
n City Sanitary Sewer Permit 1 City Plumbing Permit
Signature Date
White Copy: Property Owner Yellow Copy: City of Eagan (Parcel F ile)
City of Eapll
NOTE: Applicable only if box is checked: 1 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:.
rev 2.23 2010