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cl;0 <br />lavti000 <br />f .l1 f City Of Orono <br />,•.,.f % Point of Sale Sanitary Sewer Service Inspection Application <br />Inflow & Infiltration I/I Compliance Inspection <br />Before any property is offered for sale/transfer an Inflow and Infiltration (I/I) Inspection must be completed. <br />The inspection will look for any improper connections or significant defects in the sanitary sewer service pipe. <br />For properties that pass inspection, the City issues a Certificate of I/I Compliance which is valid for 10 years. <br />Properties that don't pass inspection are issued a correction notice delineating the problems. Repairs should be <br />completed within 90 days of the first inspection. If repairs cannot be completed prior to the transfer of a <br />property, proof of an escrow equaling 110% of the estimated cost of repairs shall be provided to the city. If <br />repairs are not completed a monthly surcharge will be applied to the utility bill until the property is in <br />compliance. See City website or call 952 249-4600 for more information. <br />Property Information <br />Property Address: / pv1? E'a,cu &- o a d. 0/'040 <br />Pm: 08-//7-23 /3 00/3 <br />Owner Information <br />Name: <br />AMCA2. orskef <br />Mailing Address: <br />(if different from <br />Property) <br />,1t -[vi // be- ch4t4gal� J2nuarcf <br />d,( 95-5 AlMn nka. Blvd �itg <br />Lwe zn A.Vod M N 63•x l <br />Phone: <br />&/2. 91,T - 733 Email: I 5noWmn/4/3 Qo% L'om <br />Fees - Inspection Fee due at time of application <br />Residential Inspection $250 Commercial Inspection: $750 <br />Pay at city hall or Call 952 249-4600 to pay by phone <br />Private Inspection Option <br />If you would like to hire a private inspector <br />instead of allowing a City inspector to <br />complete the inspection please provide the <br />following. See private inspection info sheet. <br />Inspection Company: <br />Inspectors Name: <br />Phone: <br />Email: <br />Signature <br />Applicants Name Own <br />Applicants Signature �ryj ,V <br />ate /z <br />Inspector: <br />City Review <br />Application Date: <br />j i an Fee Paid: Yes ❑ No <br />Inspection Date and Time: <br />13,1161a0ab9:00 q,m. <br />Inspector: <br />Compliant: ❑ Yes ❑ No <br />n, <br />If not compliant --- <br />Corrective Action Required: <br />Corrective Action Due by: <br />Re -inspection Date & Time: <br />Inspector: <br />Compliant: ❑ Yes ❑ No <br />Certificate of Sanitary Service Line Inflow and Infiltration Compliance <br />Date: <br />Certificate of Compliance <br />Expires: <br />Signature: <br />Name: <br />