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City Of Orono CERTIFIE`_ <br />Point of Sale Sanitary Sewer Service Inspection Application EXPIRES: ^` <br />f Xff IOf'� <br />Inflow & Infiltration (1/1) 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 UI 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 />oi��� ska.dywcod <br />©rorty, yutN 5-S341 _ <br />PID: <br />ill},13c'�ootG <br />Owner Information <br />Compliant: 0 Yes No_ <br />Name: <br />&q- r <br />S a ie +Mo.r o <br />Mailing Address: <br />(if different from <br />Property) <br />Re -inspection Date & Time: <br />Phone: <br />Sf ? - 3 7 b l w'i <br />Email: corn,. <br />Fees - Inspection Fee due at time of application <br />Residential Inspection $250 <br />Pa), at city hall or Call (952) 249-4600 to pay <br />Commercial Inspection: $750 <br />by phone <br />Private Inspection Option <br />3—Z`�— J, <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 />Name: <br />Applicants Name <br />Applicants Signature <br />Date <br />c <br />v <br />n <br />City Review <br />Application Date: <br />AD dj Fee Paid: —AYes Ci No <br />Inspection Date and Time: <br />10,11 0 1Zf <br />Inspector: <br />Compliant: 0 Yes No_ <br />If not compliant--- <br />CorrectiveActionRequired: <br />_�(�_ ad <br />Corrective Action Due by:jL1_ <br />Re -inspection Date & Time: <br />Inspector: <br />Compliant: Q Yes 0 No <br />Certificate of Sanitary Service Line Inflow and Infiltration Compliance <br />Date: <br />3—Z`�— J, <br />Certificate of Compliance <br />Expires: 3— <br />Signature: <br />Name: <br />