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City Of Orono <br />;1 <br />Point of Sale Sanitary Sewer Service Inspection Application <br />�C)"ao <br />a4'h. <br />CERTIFIED <br />SIRES: I -a-7 - 8) ON <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/I 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 />e;1 DCS ede400c r . (i 0 H 0 <br />PID: <br />C9 C) QL77 <br />Owner Information <br />Name: <br />2c ' <br />Mailing Address: <br />(if different from <br />Property) <br />( <br />_ �� �'tS_ c. 1� tl V <br />Phone: <br />X/07 - 1 Email: I o <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 r s f <br />Applicants Name (_ Z, <br />Applicants Signature.. ' :>-- - , <br />Date l <br />Corrective Action Due by: <br />j <br />City Review <br />Application Date: <br />Fee Paid: <br />I KYes ❑ No <br />Inspection Date and Time: <br />1 a ALV, p <br />Inspector: <br />Compliant: Yes ❑ No <br />oCorrective <br />v <br />If not compliant--- <br />Action Required: <br />Corrective Action Due by: <br />Re -inspection Date & Time: <br />oInspector: <br />Compliant: ❑ <br />Yes ❑ No <br />Certificate of Sanitary Service Line Inflow and Infiltration Compliance <br />Date: <br />(2."I a03) <br />Certificate Certificate of Compliance <br />Expires: <br />a1� <br />I <br />Signature: <br />Name: <br />j <br />