Point of Sale I nspection Application

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City Of Orono Point of Sale Sanitary Sewer Smice Inspection Application I lefore it] ly propert} is offered ror saWtviuIs-fer an Inflow and I n It I (ration (1/1) 1 nspcct ioll must be co In pie ted. Tho inspection will look for any improper connection,-; or significant defects in the Sanitary sc\ver Service pipe. For properties that pass inspection, the Cit} issues U COrtilka(e of 1/1 Compliance which is valid tar 10 years. Properties that don't pass inspection are issued a correction notice delineating the problems. Repair, should be C4111IIA"ted �ilhin 90 duv,; ol'thc hyst inspection. Ifrcpairs cannot Im completed prior to the transfer ofa property, proof of an escrow equaling 1100/,, of the estimated co.,j of repair shall be provided to the city. If repairs are not completed a monthly surcharge will be applied to the utility bill until the property is in compliance. See City websitc, or call (952) 2,19-4600 for more infibratation. Property Information CttymReview Property Address: PID: Application Date: Fee Paid: t) Yes D No Owner In fonnafi6n Inspection Date and Time: Name: 1 Inspector: Mailing; Address: Of di ITetent rroni Property) -Compliant: U Yes 11 No Phone: (Dt ;L - 3 -1 A I If not compliant— Corrective Action Required: 'Fee's - Inspection FmLd time of applicati6n Residential lnspcc(ioll $250 Commercial Inspection, $750 Pa) at eiiy hall or (,*all _- 249-4600 to Phone Private Inspection Qptlon� Re -inspection Date If you would like to hire a private inspector instead of allowing a City inspector to complete the inspection please provide the following. See private inspection info she, Inspection Company: Inspectors Name: Phone: Email: Si neuro Z Applicants Name Applica its Signature Date CttymReview Application Date: Fee Paid: t) Yes D No Inspection Date and Time: Inspector: -Compliant: U Yes 11 No If not compliant— Corrective Action Required: Corrective Action Due by: Re -inspection Date Inspector: Compliant: Yes No Certificate of Sanitary Service Line inflow ane! Infiltration Compliance, Datc; Certificate of Compliance Expires-, -Signature: Name: