IR - 75074J
January 16, 1990
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# 00 � �
CITY OF FRIDLEY
UTILITY LINE REPAIR/RELOCATION INSPECTION REGIUEST
Job Address: 136 Panorama Date: 1/16/90
Owner: Edwin Watkins
Legal � No. Block naan+«,
ne�...c.,•�.,., 4 2 Carlson's Summit Manor S
Ptumbing Co.: �ner Master Lic. #
1 agree to call for inspections after uncovering the damaged line, before any repairs
are made, and again when th�repa� is ma�ore recovering the line.
C� _ � � � �
INSPECTION FEE
Water Line ❑ Sewer Line $] Repair � Relocation ❑
Fee: Fee: 15. 00 per Chapter 206, Fridley Ciry Code
Total: $15.00 Receipt # 3 y� oD
INSPECTION RESULT
Approved ❑ Denied � Comments
Inspector: Date:
White Copy—Inspection Dept. • Yellow Copy—Plumbing Co. • Hard Copy—Water Dept.
e
.
#
CITY OF FRIDLEY
UTILITY LINE REPAIR/RELOCATION INSPECTION REGIUEST
Job Address:
Owner:
Date:
Legal I�t No. Block Addition
Description
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 C
Fee: Fee: Per Chapter 206, Fridley City Code
Total: Receipt #.
INSPECTION RESULT ��
Approved� Denied ❑ Comments ��.-c� ./1.Pit-�`�c-c��(JJ.� �
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Inspector: D :a et % ' % � — 9�
White Copy nspection Dept. • II py—Plumbing Co. • Hard Copy—Water Dept.