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7A - SSTS Inspection Program
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03-20-2014 Planning Commission Meeting
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7A - SSTS Inspection Program
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4/22/2016 9:15:24 AM
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SSTS INSPECTION AUTHORIZATION FORM <br /> Please fill out the areas below and return,along with your payment of$XXX.00,to the CITY OF PEQUOT <br /> LAKES. Checks should be made payable to CITY OF PEQUOT LAKES. All Inspections should be <br /> completed by XXXXXXX. <br /> Name: <br /> Mailing Address: <br /> Mailing City,State and Zip Code: <br /> Preferred Phone Number: <br /> Alternate Phone Number: <br /> Email Address(if available): <br /> As the owner of property located at (please enter your Pequot Lakes property address) <br /> Pequot Lakes, Minnesota, we are electing to <br /> have the City of Pequot Lakes' designated Inspector conduct a Compliance Inspection of our sewage <br /> treatment system. After notifying us of the date and time of the Inspection, the Inspector may come <br /> onto the property to conduct the Inspection. I understand that the Inspector will not enter any <br /> buildings, is not responsible for any activities being conducted on the property beyond the Inspection of <br /> the sewage treatment system and will provide the City of Pequot Lakes and me with a copy of the <br /> Compliance Inspection Report upon completion of the Inspection. I have enclosed $XXX.00 to pay for <br /> the cost of the Inspection. <br /> (Sign on the line above) (Date) <br />
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