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MONO CERTIFIED <br />City Of Orono EXPIRES: 1 l al ao31 <br />3V Point of Sale Sanitary Sewer Service Inspection Application <br />'� fSHnak <br />Inflow & Infiltration V 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. CERTIFIED <br />Property Information <br />Property Address: 4109 NORTH SHORE DRIVE, MOUND MN 55364 <br />PID: 07-117-23-44-0037,0038 & 0039 <br />Owner Information <br />Name: <br />James M Cleary Estate <br />Mailing Address: <br />(if different from <br />Property) <br />c/o Amy Binning, 8685 Grier Lane, Eden Prairie, MN 55344 <br />Phone: <br />612-202-9833 Email: I Amy@horizonagency.com <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 />Si... <br />afore <br />Applicants Name <br />Applicants Signature <br />Date <br />�J <br />City Review <br />Application Date: <br />I/ILA Q0 .41 Fee Paid: <br />Yes 0 No <br />Inspection Date and Time: <br />I /14 1 zzal D <br />Inspector: <br />MAkUL4Q- <br />Compliant:A 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 />4- <br />Inspector: <br />Compliant:0 Yes <br />0 No <br />Certificate of Sanitary Service Line Inflow and Infiltration Compliance <br />Date: 1/ I a� <br />a0 <br />Certificate of Compliance <br />Expires: <br />I <br />Ic`. I a03) <br />Signature: <br />Name: <br />-eS <br />�J <br />