P - 81319�III�II�IIIIIIIIIINN�INIIII�I IINNNIII 1n82�1 U�iv Ss y0A eLRm. SR�28,LStNS PEMNION04 ��,-s��,.4_..
�" 0 3 9 3 7 1 9 Q* Pno�e fsi2J sa2-oaoo �'-�' �
ome Duplex Apt. BId9. Other: n / New ddn
ommercial Industrial Farm ad�tlon J�� e'1 Remod epair
Air Cond. Htg. Equip. Water Htr. Load Mgmt Other.
Dryer Range ❑ Elec. Heat 0 Temp. Service
' abwe the wur vcved by this uesL Entei ks in ihis �ace and wr [he back ot ihe wbite cq�y onty.
5�8B�19B6 � Isispected Loealy
Robert Clauson
Ca/yn�ac �yeac�b%i�t1 ThLS Inspec[ion Request will nof be accep[ed without Ihe co�ect iee:
Other Fee +� Servire EnVance Size Fee � Circuits/Feeders Fee
Mobile Home Park Stall 0 to 00 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200_Amps Above 100_Amps I
TransformeNGenerator MSPecrqe�s use oNyr TOTAL $� � I
Sign/Outline Ltg. Xfmr. l��� •'� 7� ~��� I
Alarm/Remote Control
Swimming Pool I hereby ceAlfy ihat I inspec[ed the elechical Instai�atlon tlesenbed herein on �he de�as s�e[etl
Irrigation Boom ao�yn-m _ _ oa� �� 9g
� Speciallns , F�n� � /
Vrvestigative Fee '�� f
THIS INSTALLATION M RED DISCONN CTED IF NOT COMPLETED WITHIN 18 NTHS.
____
OFFICE USE ONLY This request voitl 18 mon�hs from valitl tlate printed in ihis b
� 393-719 0(� •� � v�
993718
PLEASE PRINT OR TYPE
Requesi Date RouoM1-in inspechon requiretl� ,s No In eet;on O(hef Than Rcu h-In
�" ❑ � 9 �� ❑ ReatlyNOw �WiIlGall
�j�'�� 11'ou must cell Ne inspedor when reatly) Oate Reatly.
I, [�icensed contractor ❑ ow�es hereby requeet inspeciion of the above elec[rical work aY
Job Adtlress (S[reeS 0�, or Route No) CAy Zip Gatle
s�s2 Ne 7m st�t Fr��y
Sadion No_ Township Name or No_ Range No. Fbe No. Gounry
Anoka
Occupant Plarie No.
Meland Construction 61 784_gggg
Power Sup0lrer Adtlress
NSP 3175 Centre Pointe Oriva, RoseviNe, MN 55173- (857J82&ZOQO
ElecVical GonVactor (Comparry Namel Conttac�or Gcense No. Mastsr Gc No. (Plant EIecL Onlyl
Aircon Electric Corporation CA00141
Ideiling Ptltlrese �Conhacto� or Owner Psriorming Ins[allation)
2343 135th Lane Nw — Arniover, MN 5530d
AiIlM�izatl 5'�gnaWra ( raoAor Owner Parforrci nsiel limj � s Phorre No.
N (B12) 757-2120 �
EB-GOOD1A-11 8/95 STqTE BOARO COPY - SEE WSTRUCTIONS ON BACK OF YELLOW COPV �
I