P - 81404- - I��IIIiIIIItiIIIIIIIIIIfIIII1flIIIfIIfIfIi REQUESTFORELECTRICALINSPECTION ���,.
Minnesota State Board of Elechicity ^� °'
1821 Unlverslry Ave., Rm. 5-128, St. Paul, MN 56104 ���
* 0 3 9 2 3 0 2 6* Phone (612) 642-0800 '���• '
Home Duplex Apt Bldg. Other: New Addn
Water Htr. X Load Mgmt Other:
Elec. Heat Temp. Service
request Eater remarks in this space and on Ihe back ol the whi[e copy
SAVER'S SWITCH INSTALLATION
ulafe Inspection Fee - This In�ection Requesf will nof be accepted without the correct /ee.�
Olher Fee � Service Entrance Sire Fee +� Circuits/Feetlers Fee
Mobile Home Park Stall 0 to 200 Amps _ I I IO to 100 Amps �_
Street Ltg./Traffic Sig_ —n Above 200 Amps I � �Above 100_Amps I
Transformer/Generator INSPECTOR'S IISE ONLY � TOTAI„/
n/Outline lta. Xfmr.
J0
JWlfflflllflg Y001 ' `� I �ereny cartity ihaf I IrsFecletl tM1e elec[ncal Installa�ion tleecri�etl herain on the tlates s[sted
Irrigation Boom � ao�5n-m oa�E
Special Inspection
Flnal � � �
Investigative Fee
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS. �
OFFICE USE ONLY Thie request voSd 18 months irwn valida�ion tlate printetl in Ihls box.
392-302�] ��a� $ �
7UB NllMSEk N5£+06dd0
PLEASE PRINT OR TYPE
RequE�t�ia��'3 ��J3 Rou9h-in Inspection requbac7 � Ycs �(Jo Irispectlor Other Then Rouyh-In: � Raedy Now 0 WIII Call
(1'ou mus[ call the Inspector when reiy) Da�e Reedy j 2� (��j � ytj
I, � licensad contractor ❑ owri6r hereby request lnspectlon of the above electrical work aT.
�p�] i��fCS9 ($IRE� BOX� IX flO�l£ �VO� CIL`J Z1jJ (�iOdB
�+�28Q� 65TH AVE NE FRIDLEY 55432
Sedion No. Townshio Name or No_ Rarwe No_ Fire No. Couniv
ANGKA
Phone Na.
7EFFREY KARL MAGS£N 571-2118
Power Supplier NtlCrese
NSP T4PL� OFPICE
Elechical Contrec�or (COmpany Name) ConVador License No-
MASTER ELEC'fRIC C6.,FNL. CA�1192
Meiling qtltlrsse (Confracto� 0� Ownor Pa�io�ming Installallon)
12467 BQS]ttE AVE S. �AVAGE: MN. 55378
o�
t 1 8i95 STATE BOAHO COPV - SEE INSTRUCTIONS ON 6ACK OF VELLOW COPV
Mester Llc No. (Plant Elact Only)
_ 7�. .