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IR - 75114�,: # 0051 CITY OF FRIDLEY UTILITY LINE REPAIR/R OCATION INSPECTION REG1UESy � . `^ �=-fA-/�.l�'l`1/�.� (�l�kiate: �'_a�� 9� J�� Ad�ress� Owner. �- � �( �� � � Legal � No. Block Description �a � Plumbing Co.: ' I agree to call f inspecti s after uncrn are made, ancj,qgain when the repair ��� Master Lic. #���5 Z the damaged line, before any repairs de but before recoverina the line. INSPECTION FEE Water Line L9' Sewer Line O Repair ❑ Relocation ❑ Fee: �� �� Fee: Per Chapter 206, Fridley City Code Total: s` � Receipt # � 3� � INSPECTION RESULT Approved � Denied ❑ Comments Inspector: Date: White Copy—Inspection Dept. • Yellow Copy—Plumbing Co. • Hard Copy—Water Dept.