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City Of Orono CERTIFIED <br />Point of Sale Sanitary Sewer Service Inspection Appli@Xf1Uis:—a-jL oi0 3 <br />Inflow & Infiltration(III) Compliance Inspection <br />Before any property is offered for sale/transfer an Inflow and Infiltration (I/1) 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 1/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 />City Review <br />Property Address: <br />9 (o (o <br />S(�v 12G' �(La�n� <br />lyt Iv S�31U V <br />PID: <br />11'1 �► 3 5 <br />Owner Information <br />pyL <br />Name: <br />wm-- <br />N <br />If not compliant --- <br />Corrective Action Required: <br />Mailing Address: <br />different from <br />Property) <br />le fpp <br />Corrective Action Due by: <br />Phone; <br />— 6+0 -cV 7,q <br />Email: n n <br />G.V :) CIMP JL• (.e <br />Fees - Inspection Fee due at time of application <br />Compliant:[] Yes 0 No <br />Residential Inspection $250 <br />Pay at city hall or Call 952) 249-4600 to pay <br />Commercial Inspection: $750 <br />by phone <br />Private Inspection Option <br />Certificate of Sanitary Service Line Inflow and Infiltration Compliance <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 />o� 0�03� <br />phone: <br />Signature: <br />Email: <br />Signature <br />Name: <br />Applicants Name <br />Apmlicant <br />' ature <br />Date <br />V 1 - ' cs <br />City Review <br />Application Date: <br />Fee Paid: Yes [] No <br />Inspection Date and Time: <br />jbi 00 <br />Inspector: <br />pyL <br />Compliant: Yes 0 No <br />v <br />If not compliant --- <br />Corrective Action Required: <br />Corrective Action Due by: <br />Re -inspection Date & Time: <br />o <br />Inspector: <br />Compliant:[] Yes 0 No <br />Certificate of Sanitary Service Line Inflow and Infiltration Compliance <br />Date: <br />o"i-C`1-1.011 <br />Certificate of Compliance <br />Expires: <br />o� 0�03� <br />Signature: <br />Name: <br />