IR - 75084#_ 0�2 �
CITY OF FRIDLEY
UTILITY LINE REPAIR/RELOCATION INSPECTION REGIUEST
Job Address: 5750 East River Road NE Date: 11/6/91
Owner: Filister Apartments
Legal �a wo. eio�k naa�no�
flwserintinn Pt 17�1 Alld. Sllb. $�78
Plumbing Co.: �'�olz Co Master Lic. #
I agree to call for inspections after uncovering the damaged line, before any repairs
are made, ��ain when the repair i�majje but before recovering the line.
INSPECTION FEE
Water Line � Sewer Line O Repair ❑ Relocation ❑
Fee: 15 . 00 Fee: Per Chapter 206, Fridley Ciry Code
Total: 15 . 00 Receipt # �/� �- � �..'�
INSPECTION RESULT
Approved ❑ Denied ❑ Comments
Inspector: Date:
White Copy—Inspeccion Dept. • Yellow Copy—Plumbing Co. • Hard Copy—Water Dept.
�
#
CITY OF FRIDLEY
UTILITY LINE REPAIR/RELOCATION INSPECTION REGIUEST
Job Address: Date:
Owner:
Legal I LOt "° I Block AddiUOn
Description
Plumbing Co.: Master 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:
Water Line �
Fee:
Total: �
INSPECTION FEE
Sewer Line O Repair ❑ Relocation C'
Fee: Per Chapter 206, Fridley City Code
Receipt #
INSPECTION RESULT
Approved � Denied ❑ Comments o9li
Inspector � Date: ��—/z— gi
�
White Copy—Inspectio Dept. • Yellow Copy—Plumbing Co. • Hard Copy—Water Dept.