P - 78921c REQUEST FOR ELECTRICAL INSPECTION
1� V��- 217 � Minnesota Board of Electricity
� 1821 University Avenue Suite S-128, Saint Pa�, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800�27-3529 www.e[ectricity.state.mn.us
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I certify that I am U�e �(CENSED CONTRACTOR ❑ COMPANY 0 OWNER and hereby request inspection of U�e electrica� wak at;