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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 ofrepairs shall be provided to the city. If� SC�o <br />repairs are not completed a monthly surcharge will be applied to the utility bill until the property is in I <br />compliance. See City website or call (952) 249-4600 for more information. <br />Property Information <br />Property Address: 3i,; Cv-r :-h-iO w A„ e . ( n'nO r./ <br />+M <br />PID: os 2 3 1 - OD > v - <br />Owner Information — <br />Name: <br />I Fee Paid: g Yes L_No <br />Mailing Address: <br />(if different from <br />Property) <br />Inspection Date and Time: <br />Phone: <br />iail: ; ( ptfii 1 'fno,t <br />Fees - Inspection Fee due at time of application <br />Residential Inspection $250 Commercial Inspection: $750 <br />Pay at city hall or Call (932) 249-4600 to pay by phone <br />Private Inspection O`tion <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 />Ins ection Company: <br />Ins ectot's Name: <br />Phone: <br />Email: <br />Signature <br />Applicants Name <br />Iilag4ts� ' <br />Date <br />C�1 ��' f`�•' � UJ <br />Inspector: <br />087Z020- <br />Co(1? <br />City Review -- <br />Application Date: <br />I Fee Paid: g Yes L_No <br />Inspection Date and Time: <br />;OO ow- b l <br />Inspector: <br />Compliant: u Yes U 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: U Yes U No <br />Certificate of Sanitary Service Line Inflow <br />and Infiltration Compliance <br />Date: <br />Certificate of Compliance <br />Expires: <br />Signature: <br />Name: <br />Co(1? <br />