P - 79970REDUEST FOR ELECTRICAL INSPECTION �•
1 ��� ��^ Minnesota Board of Electricity
_ � ( *- 1827 Unrvereiry Avenue Su�ie 5-128, Sain[ Paul, Minnesota 55104 3
�� (651) 642-0800 TTY/MRS 1-800-6273529
� �[ �('�%� www.electricity.state.mn.us
❑REPAIR � `� ���,�'`S �Y'/ ��CC.-
Inclutles the Service anNor Power SuDPN up to 500 AmOeres, All
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I certlfy that I am the � LICENSED COMRACTOR ❑ COMPANY ❑ OWNER and here6y request ii�pection ot the electrical work aY.
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