P - 82395REQUEST FOR ELECTRICAL INSPECTION �
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1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104-2993
(651) 642-0800 www.electricity.state.mn.us `'�'
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Calculaie Inspection Fee - This Inspection Request will not be accepted without ihe correct iee:
Other Installafions Fee # Service Entrance Size Fee # Circuits / Feeders Fee
Mobile Home Park Stail 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
Sign / Outline Ltg. Xfmr. �v ��v
Alarm/Remote Confrol
Swimming Pool
I hereb certi fhat I ins ected the elechical installation described herein on the dates stated:
Irriaation Boom a„��„ti.i� Da�e
Investigative Fee ' ���� � ����'�� ��" � c2- �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This requesf roid 18 monihs from validation daie printed in fhis box.
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PLEASE PRINT OR TYPE
Requesf Dafe Rough-in inspection required2 ❑ Yes ❑ No Inspection Other Than Rough-In: �@eady Now ❑ Will Call
�—�—�Qp You must call the inspector when ready Date Ready:
I, �.licensed contractor ❑ company ❑ owner hereby request inspection of the above electrical work at: