P - 76359ORDER FOR PAVMENT NO. I
'Z�. �e�7 � ao �. �� DER �
�nstaller of Wiring _ /� � /� ��/
Owner/Occupant ���l�-tF%� st ��. m� Job �°z�/
i
PropertyAddress / �(� � 07�},er��•. %��f �p��
Date Permit No. _���d'A'�� pate Filed �Y3 a'°%
❑ Addftional rough-in inspection was requfred.
O No access - scheduled inspecticn. � �� r� ��
�hortage - see computation. ��v
❑ Reinspectton fee. ��� �A p�/ 1�I Z007
I�►� H r 1 1
Fee Computatlon:
r�- / i..� 4�7 . f-LPJ. 6�-a
,,'. - , -
n' ��y
:1 ! � i . .��ri'i/
�
- ��
�
� CITY OF FRIDLEY
6431 UNIVERSITY AVE NE
FRIDLEY MN 55432
ad
Please retum this order�w�'th your c in the areiount of __��' -- � nayable to the city/
��Y {date) r7b �i�� --�'j
Inspector �c5 � ��p� u C �-� Telephone �s,�/- % � % ? �'a'�
RETURN THIS ORDER WITH PAYMENTTO'fHE CITYlTOVYNSHi� WHERE THE JOB IS LOCATED. w�_n�