P - 79128�EQUEST FOR ELECTRICAL INSPECTION
�� 7 1 2� 4� O `( j. I Minnesota Board of Electricity -
u 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTYIMRS 1-800-627-3529 www.electriciry.state.mn.us
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// r/� � 4 You must call the inspectar when ready! Date Ready:
I certify that I am ttie
and he►ebY ►eQ�t inspection of the electrical wrork at: