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*036326Q7*
Home Duplex AF
REQUEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Electricity
1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone(612)642-0800
Other: New
�ommercial Industrial Farm Remod
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
above the work covered by this request. Enter remarks in this space and on the back of the white cqoy only.
SAVER'S SWITCH INSTALLATION
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Addn
Calculate lnspection Fee - This lnspection Request will not be accepted without the correct tee:
Other Fee � Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTAL , (i
Sign/Outline Ltg. Xfmr. 15.��
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
X Speciallnsp . l,
Final D
Investigative � �``l1�.�--°�. �� �
�_ THIS INSTALLATION MAY BE ORDERED DISC_NNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-260�
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JOB HUTIBER �9706000
PLEASE PRINT OR TYPE
Request Rough-in inspection required? ❑ Yes o Inspection Other Than Rough-In: Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: %� 1%� 9%
I, u licensed contractor ❑ owner hereby request inspection of the above electrical work at:
J�0604�0reet, Box, oSTHN��T HE F�tIDLEY Z�P55432
Section No. Township Name or No. Range No. Fire No. County
ANOKA
Occupant Phone No.
CHARLES R CARIOLAHO
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Company Name) Contractor License No.
KASTER ELECTRIC CO.,INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S. SAVAGE ItN. 55378
Authpri�d Sign�tujk (Contr�ct or Owner Performing Installation)
574-7503
1 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
Master Lic. No. (Plant Elect. Only)
No.