IR - 75138,
Pre�ook�P Inspection Requi�ed
�i�x To Connection To City Line
# 0007
CITY OF FRIDLEY
UTILITY LINE REPAIR/RELOCATION INSPECTION RE�UEST
Job Address: 181 Talmadge Way N. E. Date: 7/5/89
Owner: Arnold Gilbertson
Legal �a No. siock nadm«,
Descri�tion Pt• 5 1 Elwell's Riverside
Plumbing Co.: o oran � �, h; ng Master Lic. #
I agree to call for inspections after uncovering the damaged line, before any repairs
are made, and a ain when th p ir is made but before recovering the line.
Signature:__���c����� e /./
INSPECTION FEE
Water Line �I Sewer Line ❑ Repair ❑ Re.location O
Fee: 15. 00 Fee: Per Chapter 206, Fridley City Code
Total: 15. 0 0 Receipt # a�� 2
INSPECTION RESULT
Approved ❑ Denied ❑ Comments
Inspector: Date:
White Copy—Inspection Dept. • Yellow Copy—Plumbing Co. • Hard Copy—Water Dept.
✓
. erefiookup lnspection Required
Prfor To Connection To C't� i e #
CI�`Y b� FRIDLEY
UTILITY LINE REPAIR/RELOCATION INSPECTION RE�UEST
Job Address: Date:
Owner.
Legal � No. Blotk nad�c�o�
Description _ ' .
Plumbing Co.: Master Lic. #
1 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
Inspect . \ Date: ��� � ���
White Copy—Inspection Dept. • Yellow Copy—flumbing Co. • Hard Copy—Water Dept.