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P - 75362OR�ER FOR PAYMENT NO. - , s� ,_ .,�,��'—. �� . ORDER FOR PAYMENT Installer of VNiring ' `°"� �' � ` �� ° � � Owner/Occupant �7 " � �°° ��`° Job �c � �� Property Address � G`� �� `�7 ��' �� Zip �� — Date ��— � ' ° � Permit No. �-�"''�`' �" "l �� " Date Flled % �'' � �" ° � ❑ Add�ionai rough-in inspection was required. � O No access - scheduled inspection. �� Q( 1�� '�E�e shortage - see computation. � ❑ Reinspectfon fee. Fee Computation: �� P� c e-� � ��e � ^ � l^�%- � J�� r��,�,�.�� C4�1 � �"d d.�' �51� 1 �s.(' �� CV �l f �Y�� L �c.e�� f `� � � CITY OF FRIDLEY 6431 UNIVERSITY AVE NE FRIDLEY MN 55432 Please return this order with your chedc tn the amourrt of ��`� aayable to the cit}r/ township by (date) //— �� " � Inspector �o� �� tS' '"�° Telephone � .9 �°�%� e �� 0�� RETURNTHIS ORDER WITH PAYMENTTOTHE CITY/TOWNSHIP WHERETHE JOB IS LOCATEO. RGp2