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IR - 75095G 0 # 0032 ' CITY OF FRIDLEY UTILITY LINE REPAIR/RELOCATION INSPECTION REG1U ST Job Address: � 7 � � � A � � � �� Date: y � r Owner. �,�1 /� P_ �-/ / i � C �%� Leg81 �a No. e�ock �aattio� Plumbing Co.: i Master Lic. #—�� I agree to cail inspection `after uncovering the damaged line, before any repairs are made, and �ain when the repair is made but t�qf�e recovering the line. � " INSPECTION FEE Water Line � Sewer Line �' Repair �, _ Relocation� Fee: � � 1% Fee: Per Chapter 206, Fridley Ciry Code Total: Receipt # ��%'� INSPECTION RESULT Approved ❑ Denied ❑ Comments Inspector: Date: White Copy—Inspection Dept. • Yellow Copy—Plumbing Co. • Hard Copy—Water Dept. i / � , # CITY OF FRIDLEY UTILITY LINE REPAIR/RELOCATION INSPECTION RE�UEST Job Address: Date: Owner: Legal �rn No. e�«k ndd�uo� 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: � " INSPECTION FEE Water Line � Sewer Line ❑ Repair ❑ Relocation� Fee: Fee: Per Chapter 206, Fridley City Code Total: Receipt # INSPECTION RESULT Approved � Denied O Comments Inspecto � c�� Date:J���Z— White Copy—Inspection Dept. • Yellow Copy—Plumbing Co. • Hard Copy—Water Dept.