P - 79353REQUEST FOR ELECTRICAL INSPECTION
1 3 21 0 7 5 Minnesota Board of Electricity
� � 1821 University Avenue Suite 5-128, Sain[ Paul, Minnesota 55104
. (651) 642-0800 TTY/MRS 7-800-6273529
www.electnciry.a�mte.mn.us
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FON OFFICE USE ONLY
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I cetlity ihat I am ihe [�I�ENSED CANTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspec1ion of ihe eledrical work at:
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