P - 75599ORDER FOR PAYME,NT NO. I
�, " 1°,-c��$'�?%4- ��ER �F�
Installer of Wirin� �� c9 o S ��,4� �;ce� �
Owner/Occupant (/ �trS �,� �j Job _��-
PropertyAddress v l7 [ v(- ,�� .�.e.rt„ �jt J ap ��
Date °% - Z-- d� Permit No. �b$�'` �Z � t{ Date Fled �'� ��^ O
O AddiUonal rough-in inspectton was required.
O No access - scheduled inspection.
� Fee shortage - see computation.
L�Reinspection fee.
/ \
Fee Computatlan:
� I A j � � 1
i i I
3� sB
Please return this order with your chedc int�e amount of ��— uayable to the clty/
townsh(p by (date) _ �%^ /� � �s 8
Inspector / CCS�` 1- C`�$�w� Telephone_ �.�/^�77% �$'�,�
RETURN THIS ORDER WITH PAYMENTTO THE CITY/TOWNSHIP WHERE THE JOB 15 LOCATED. RC-02