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P - 75800
ORDER FOR PAYMENT NO. � -- I -3 ��-S �a ._, ��;, � : -�� -.• � 1. Installer of Wiring � � RrerL Owner/Occupant �� ���� s� �'`�4 Job _y�u� ���X Property Address L �/ % " � ' /�°« � C� 2 �" ZtpSS'�2 / Date .j� �t�I� ��i Perrr►it No. �~ ��%— S�� Date Filed % J—�S �Addkional rough-in inspection was required. O No access - scheduled irrspection. �� �j ❑ Fee shortage - see compu4ation. ❑ Reinspectfon fee. • Fee ComputaUon: (ii:� ��.5'�e► *� �� Piease retum this order �ur check in che amount of 4��' �ayable to the city/ township by (date) Inspector — Telephon� `c,��'��� � p oJ RETURNTHIS ORDER WITH PAYMENTTOiHE CITY/TOWMSHIP WFIERETHE JO� 15 LOCAiED. RC-02