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Authentisfgn ID: 353BB2D2.04B6.479A-BEDD-9393E1782367 <br />City Of Orono <br />Point of Sale Sanitary Sewer Service Inspection Application <br />\��K[SIIna� <br />CERTIFIED <br />y <br />EXPIRES: <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 />Property Address: 1000 Old Long Lake Road <br />PID: 31-118-23-13-0003 <br />Owner Information <br />Name: <br />Laurie Erlandson <br />Mailing Address: <br />(if different from <br />Property) <br />501 Carlson Parkway #102 <br />Minnetonka, MN 55305 <br />Phone: <br />6b1-270-1632 Email: laurie.erlandson mail.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 />Signature <br />Applicants Name <br />Applicants Signature <br />Date <br />Laurie Erlandson <br />ut ent0c>lr <br />Rade Uar�on, <br />u <br />01/05/2021 <br />11512021 3:42:20 NM G51 <br />M <br />City Review <br />Application Date: <br />1 5 <br />a <br />Fee Paid: Yes ❑ No <br />Inspection Date and Time: <br />t/'I <br />., 0o PM <br />Inspector: <br />O1t., KSi.1C. <br />Compliant: Yes ❑ No <br />a <br />Cz <br />v_r <br />If not compliant--- <br />Corrective Action Required: <br />Corrective Action Due by: <br />Re -inspection Date & Time: <br />o <br />Inspector: <br />Compliant: ❑ Yes 0 No <br />Certificate of Sanitary Service Line Inflow <br />and Infiltration Compliance <br />Date: t/1 <br />Certificate of Compliance <br />Expires: <br />1 ZD31 <br />Signature: <br />Name: <br />M <br />