IR - 75127, �
- # 0_ _064
CI'�Y OF FRIDLEY
UTILITY LINE REPAl�i/RELOCATION INSPECTION R GIUEST
Job Address: ��3� 3�-� Date:
Owner: ���..5
Legal � N�o./ Block /J � naan� (^
Description `7 � C_�/��.��,5 �,[,�/Z��3'U
'r�f1"�c/U i� � ��s�•�- •
bing Co.: ��—��,.,, Master Lic. #
I agree to ections after uncovering the damaged line, bebre arry repairs
ar ade, an n the repair is made but before recovering the line.
Signature:
INSPECTION FEE
Water Line ❑ Sewer Line L7 Repair O Relocation O
Fee: �� Fee: 15 . 00 � per Chapter 206, Fridley City Code
Total: � � Receipt # 1S
INSPECTION RESULT
Approved ❑ Denied ❑ Comments
Inspector: Date:
White Copy—Inspection Dept. • Yellow Copy—Plumbing Co. • Hard Copy—Water Dept.
.
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#
CITY�OF FRIDLEY
UTILITY LINE REPAIR/RELOCATION INSPECTION REt�UEST
Job Address: �` � 1 � 2� � Date:
Owner:
Legal �� No. Block nc
Description '� � ��¢�(Sp�`S
Plumbing Co.:�Ol� �KOa /�� '��� Ma er Lic. #°'���^
I agree to call for inspections after uncovering the damaged line, before any repairs
are made, and again when the repair is made but before recovering the line.
Signature:
INSPECTION FEE
Water Line � Sewer Line ❑ Repair ❑ Relocation r
Fee: Fee: Per Chapter 206, Fridley City Code
Total: Receipt # l�
INSPECTION RESULT
Approved � Denied � Comments ja� � �' �J�ti'd' •
a��; .�ne.UC, a�[ � �%Ji�L�' .L�. ,L�J',
Inspector: � w Date: �- I%— 9�
White Copy spection Dept. • Ilow Copy—Plumbing Co. • Hard Copy—Water Dept.