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stip to,,, OOC/fn <br />City Of Orono <br />Point of Sale Sanitary Sewer Service Inspection Application <br />Inflow & Mltration 1/ Co fiance In on <br />Before any property is offered for sale/transfer an Inflow and Infiltration (111) 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/1 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 he applied to the utility bill until the property is in <br />compliance. See City website or call 952 2494600 for more information. <br />Yroperry ttuorrnanon <br />Property Address: <br />Application Date: <br />PID: Z7 <br />Owner Information <br />Name: <br />Inspection Date and Time: <br />Mailing Address: <br />(ifdifferent Brent front <br />Property) <br />Inspector: <br />Phone: <br />as , q 7 Z 1 c• Z <br />F tion Fee due at time of aEplication a C- <br />esi nspection $250 <br />city hall or Cal! 952 219-1600 t" <br />Commercial Inspection: 5750 <br />ay 6 hone <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 />Ins pection Compan : <br />Inspectors Natne: <br />phone: <br />Email: <br />Signature <br />Compliant: ;-: Yes No <br />A licants Name <br />Anplicants Signature Date <br />w4 -1 <br />+j -C.Ory-% <br />City Review <br />Application Date: <br />Fee Paid: L! Yes l No <br />Inspection Date and Time: <br />Inspector: <br />Compliant:.*t Yes • , No <br />o, <br />If not compliant— <br />Corrective Action Required: <br />Corrective Action Due by: <br />Re -inspection pate &Time: <br />Inspector: <br />Compliant: ;-: Yes No <br />Certificate of Sanitary Service Une Inflow and Infiltration Compliance <br />Date: <br />Certificate of Compliance <br />Expires: <br />Signature: <br />Name: <br />w4 -1 <br />+j -C.Ory-% <br />