P - 81158Y
o-s5s-326 20
REQUEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Electricity -
1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104-2993 =_
(651) 642-0800 www.electricity.s[ate.mn.us
'K" above the work covered by this request. Enter remarks in this space and on the back of the white copy on/y.
N3P 3AVER'3 3WITCH
Calculate
Mobile Home Park Stall
Street Ltg. / Traffic Sig.
Transformer/Generator
Sign / Outline Ltg. Xfmr.
Alarm/Remote Control
Swimmina Pool
Fee -
will not be
0 to 200 Amps
Above 200 Amps
INSPECTOR'S USE ONLY
I insoected the electrical
without the correct fee.
�irouits / Feeders Fee
0 to 100 Amps
Above 100 Amps
TO
�• S�
n described herein on the dates stated:
n i iyauv� i uvvn �.. ROUgh 10 Ufli6
Speciallnspe n
Fnal � .._ /�'j�>/
Investigative Fee �
THIS INSTALLATION MAY BE ORDERED DI NECTED IF NOT COMPLETED WiTHIN 18 MONTHS.
._.. _. _-_.. ____._.__...._,..,__.__._......,,,..-�....,..., ��E USE OI�Y T}ps request void 18 moMhs irom validation daie primed in this box.
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PLEASE PRINT OR
Req��StJ}4p,,,t Rough-In inspection required7 � Yes ❑ No Inspection Other Than Rough-In: � Ready Now ❑ Will Call
7 �!'12Ni;1!!
You must call the inspector when ready! Date Ready:
A
I, ❑ licensed contractor ❑ company ❑ owner hereby request inspection of the above electrical work at:
Job Addre�i6lEeet, Bax, QcAo�Mf�y�� � ��H FRtDtEY zp +'i4�IJd
aV QLIYV �q
Section No. Township Name or No. Range No. Fre No. Count�O�
Occupant gpHNETT MARVIN A1.LEN �'°"8 "°. -
Powe�S�lier Address _�.�
rvar.
Electrical Contractor / Com n Name Contrector License No. Master Lic. No. (Plant Elect. Only)
HUNT ELEG'�R�C Ct7RPORATt4N CA 00�98;3
Mailin,C.7lA) ItKKII(�ilA1.yKSlP►I.lPeaf11fl1 K�VL� MN ��h4
Authorized Signature (Co rpm n or Owner Performing In I6 on �/ Phone Number
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EB-00001A-12 5/1999 STATE BOARD COPY SEE INSTRUCTIONS ON BACK OF YELLOW COPY