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P - 76812�� ORDEI� F�R PAYMENT . �� G' 4 OO� �� o/ �'3� �RDER �A Instailer of Wiring Owner/Occupant _ � �i � A-� f — � IL, � �[ �{,�, � d _ Job �f+� � 1 i .x. Property Address 1 y- ��l �'�- Zip\.�- �2 Date _�y „� °^ a'7 Permit No��z-� C L�� Date Filed _�'� �! � o ❑ Additional rough-in inspection was required. ❑ No access - scheduled inspection. ❑ Fee shortage - see computation. L�J'I�einspection fee. Fee Computation: •i Wl � � � � � �`� CITY OF FRIDLEY . - 6431 UNIVERSITY AVE NE — FRIDLEY MN 55432 '` � __ _ _ _ �t�i � �� Please return this or�yr wfthy� u� h�k in amount of ` payabie to the city/ township by (date) �� --C-K-�`'lSST� Inspector _ ///f�� %` ��}�S �� Telephone �c ��'- %'� . 7�01� RETURNTHIS ORDER WITH PAYMENTTOTHE CITY/TOWNSHIP WHERETHE JOB IS LOCATED. RC-�2