The URL can be used to link to this page

P - 74951CITY OF FRIDLEY ,�-� �� WATER AND SEWER CONNECTION PERMIT APPLICATION �� il.c,i C�J �-.� S Date: Owner 9r, Plumber) Job Address: � � � � �- lOT N� LEGAL DESCRIPTION T-- PERMIT: Y^ �� BLOCK �a i� ,��— RACT OR /� OITION�. �- �- �,c.,� v � �� - �", SEWER: WATER: METER: FEE:�� FEE: /� GU DEPOSIT: O-DAPTER: STATE .� STATE � � SURCHARGE: SURCHARGE: TOTAL: �� TOTAL: /� � OTAL: � / OU GRAND TOTAL: �� S.A.C. CHARGE ON EXISTING STRUCTURE: EXISTING STRUCTURE: NEW STRUCTURE: BUILDING PERMIT No.:`�°'�� SEWER/W�ATER PERMIT NO.: �'3 SPECIAL ASSESSMENTS: Si ned� �''"" ��-'-'`=�� r' 9 .� - By: I