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5�k'511 3 a- <br />City Of Orono <br />yf` _ Point of Sale Sanitary Sewer Service Inspection Application <br />kesu�a� <br />Inflow & Infiltration (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 I/1 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: <br />302(., CIASCD Poiw( Rd WO\ 2Q MN 553011 <br />PID: <br />Z 0 - 117 - - 00 Z lv <br />Owner Information <br />`,o <br />Name: <br />AWRONY + 191NAi)eWmmJ <br />Mailing Address: <br />(if different from <br />Property) <br />If not compliant --- <br />Corrective Action Required: <br />Phone: <br />Email: <br />a) (, DW <br />Fees - Inspection Fee due at time of application <br />o <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 Com an : <br />Inspectors Name: <br />phone: <br />Email: <br />Signature <br />Signature: <br />Applicants Name <br />A pli ants Signatur <br />Date <br />fZ N -rc�r��N <br />bel /off i2 � <br />U <br />City Review <br />Application Date: <br />41.161 a -k I Fee Paid: Yes 0 No <br />Inspection Date and Time: <br />Inspector: <br />`,o <br />Compliant:X 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 />Com pliant:0 Yes 0 No <br />Certificate of Sanitary Service Line Inflow and Infiltration Compliance <br />Date: <br />Certificate of Compliance <br />Expires: <br />Signature: <br />Name: <br />U <br />