P - 80583, REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Eleciriciry
1-380-314 � 1821 Universiry Avenue Suite 5428, Saint Paul, Minnesota 55104
[857)642-0800 TTYlMRS 1-800-627-3529
www. electricit y. sta te. mn. us
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I certify ihat I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of ihe elecirical work at: