P - 77532J ��Ct v�n�� � �� 1 -- � �2 ( �' _
ORDER FOR PAYMENT NO. �-l( � G
� -���7-- G�i6S �RDE�
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Installer of Wiring � c, � 5 J��� ,. -.-
Owne Occupant Job ���f�
Property Address � �� � " � � �o .� � , ZiP � �, � {�
Date � ' � `f � � "� PermR No. I ff �� - ��( Date Filed � � �-- � `7
❑ Additional rough-in inspection was required.
O No access - scheduled inspection.
❑ Fee shortage - see computation.
I�Reinspection fee.
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Fee Computation:
II _ 027� v'7
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� CITY OF FRIDLEY
6431 UNIVERSITY AVE NE
FRIDLEY MN 55432 — ��-��—
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Please return this order with check in the amount of _ ��� � payable to the city/
township by (date)
Inspector ,1 C�b,y � ^ � �l� S �5x Telephone � �� 7/�% % �`���
RETURN THIS ORDER WITH PAYMENT 70 THE CITY/TOWNSHIP WHERE THE JOB IS LOCATED. Rc-c»