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2 9,51 <br />CERTIFIED <br />EXPIRES: L4 -(L4 - a03 <br />City Of Orono <br />Point of Sale Sanitary Server Service Inspection Application <br />Inflow & infiltration I/I .Com liance.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. <br />Property Information <br />Property Address: <br />PID: <br />Application Date: <br />Owner Information <br />Name: <br />Inspection Date and Time: <br />Mailing Address: <br />(if different from <br />Property)��•/` <br />z)s— <br />O Wpq I•�JJI,/ s -� s�� 6 <br />V <br />Phone: <br />Email; C5G_ 5ti:, GO <br />Fees - Inspection Fee due at time of Application . <br />Residential Inspection $250 Commercial Inspection: $750 <br />Pay at ci 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 />Corrective Action Due by: <br />phone; <br />Email: <br />Compliant:0 Yes 0 No <br />Signature <br />Ap ' nts Name <br />Applig4nts Signature <br />Date <br />or <br />Date: <br />4-14 - a <br />N <br />Application Date: <br />L4 -t >- 'ell I Fee Paid: A Yes 0 No <br />Inspection Date and Time: <br />4-14-11 4: QG 4M <br />Inspector: <br />, <br />Compliant: Yes 0 No <br />at <br />If not compliant --- <br />Corrective Action Required: <br />Corrective Action Due by: <br />Re -inspection Date & Time: <br />Inspector: <br />Compliant:0 Yes 0 No <br />Certificate'of Sanitary Service Line Inflow„atid`Infiltration Compliance . ,'•..: ...: ;.... <br />Date: <br />4-14 - a <br />Certificate of Compliance <br />Expires: y-\`1- QL031 <br />Signature: <br />Name: <br />N <br />