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ci:d Ua&%j <br />1avti0-ao <br />City Of Orono <br />Point of Sale Sanitary Sewer Service Inspection Application s(7� <br />Inflow & Infiltration UI 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 Citywebsite or call (952) 249-4600 for more information. <br />Property Information <br />Property Address: <br />lollo a4zo_wa, oad, Orono <br />PID: <br />48^ //7 23 /3 0013 <br />Owner Information <br />Name: <br />J a, or5ke- <br />Mailing Address: <br />(if different from <br />Property) <br />0-4o/// be chingtd in JOAUu y <br />d1 qs5 M�'nn aka B/vd$ <br />AW <br />Phone: <br />&/Z. 8 - - 73 Email: I 5notn/Mn 1A/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 ats,lelrz pit' <br />Applicants Signature <br />Inspector: <br />Compliant: ❑ Yes 11No <br />o-19 <br />City Review <br />Application Date: <br />jaiI an Fee Paid: Yes ❑ No <br />Inspection Date and Time: <br />1.1116laoQ69: oo o n-, <br />Inspector: <br />^t & qAL, C, irk. <br />Compliant: ❑ Yes Y No <br />o <br />v <br />If not compliant--- <br />Corrective Action Required:^`- <br />}U� <br />Corrective Action Due by: <br />Ja:m aoa.1 <br />Re -inspection Date & Time: <br />n <br />Inspector: <br />Compliant: ❑ Yes 11No <br />Certificate of Sanitary Service Line Inflow and Infiltration Compliance <br />Date: <br />Certificate of Compliance <br />Expires: <br />Signature: <br />Name: <br />o-19 <br />