P - 75668ORDER FOR PAYMENT NO.
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��D AU G 1 � 2007
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Installer of Wtring J^^r+ V�lt < �Gee�'� ��0� �
Owner/Occupant � � Gc ��� e�r Job
Property Address l�� ' d�� �-��n A� Cl Z �p �,s`� Z
Date Permk Na ��'�/�'� �"g% Date Filed G^�c �—c%
rough-in Inspection was required.
O No access - �cheduled inspection.
� Fee shortage - see computa4lon.
❑ Reinspection fee.
Fee ComputaUan:
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� CITY OF FRIDLEY
6431 UrTIVERSITY AVE NE
FRIDLEY MN 55432 •
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Please retum this order withy o�ur chedc in the amount of f—� •�' payable to the ciry/
township by (date) � ^ .�5 ^o%
Inspector ��-�-�jo�✓L Telephone �.5�`��"7���
RETURN THIS ORDER WRH PAYMENTTO THE CITY/TOWNSHIP WHERE THE JOB IS LOCATED. RC-02