4839 Richard Lane - COCCity of Eagan
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
Yellow Copy: City of Eagan (Parcel File)
4 , 6 ' City of Evan
City of agan, Minnes to
Property Address: g3 i c„.„,h. 27L L
COMPLIANCE WITH INIIIAL INSPECTION
This is to certify that the property listed above has been inspected by authorized City personnel on 16 2 , 201 C
and found to be in compliance with Section 3 40 of the City Code and no corrective work was required
COMPLIANCE AF I ER CORREC TIVE 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 Sanitary Sewer Permit n City Plumbing Permit
NOTE: Applicable only if box is checked: [jBased 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: 1 { c� tl I �� `-'.� I �j c , i
Print name Signature Date
rev 2 23 2010