The URL can be used to link to this page

P - 74937CITY OF FRIDLEY WATER AND SEWER CONNECTION PERMIT APPLICATION Name: i / � � / Job Address: ''� LEGAL DESCRIPTION PERMIT: �i v�e� vi �� / te� Owner or Plumber) ) / / .�i_�i �� ( !�" F% !�L O. /BL�O�CK '.. , � 1.2J ✓ SEWER: FEE: °�� 0O .�.....+ ACT WATER: '�' METER: FEE: �`� '� DEPOSIT: % ` g 19�� O•DAPTER: STATE , �(� STATE S'"� SURCHARGE: � SUACHARGE: ` TOTAL: °?'�' ' S� TOTAL: �S S� TO AL: � OU � GRAND TOTAL: �/' � S.A.C. CHARGE ON EXISTING STRUCTURE:. � r EXISTING STRUCTURE: NEW STRUCTURE: BUILDING PERMIT No.: °` ��a � � SEWER/WATER PERMIT NO.:� SPECIAL ASSESSMENTS: Signed: L I� S iu ��c WC �, . gy ; ';�-�C�'ti-� f� _