P - 83734' III�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII REQUESTFORELECTRICALINSPECTION �-���
Minnesota State Board of Electncity �
1821 University Ave., Rm. S-128, St. Paul, MN 55104
� * 0 3 6 3 3 1 0 4* Phone (612) 642-0800 '�`'� s�
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
"X" above the work covered by this request. Enter remarks in this space and on the back ot the white copy only.
SAVER'S SWITCH INSTALLATION
Calculate Inspection Fee - This Inspection Request will not be accepied without the correci tee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200_Amps Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTA�S �
1 .
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming �i I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Special Inspection
Finai
investigative Fee �` Z"� ��
THIS WSTALLATION MAY BE ORDERED DIS �__ECTED IF NOT COMPLETED WITHIN 18 MONTHS.`_
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-310 �f � �3 Sd �
��5� JOB NUMBER �9706000
PLEASE PRINT OR TYPE
Request Rough-in inspection required? ❑ Yes o Inspection Other Than Rough-In: Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: 7� 17 � 97
I, licensed contractor ❑ owner hereby request inspection of the above electrical work at:
�or�,��5�,�reet, Box, o�No�T NE �'iIDLEY Z"��432
Section No. Township Name or No. Range No. Fire No. County ANOKA
Occupant Phone No.
EARL G HATTEN 571-4142
Power Supplier Address
NSP MPLS OF'FICE
Electrical Contractor (Company Name) Contractor License No. Master Lia No. (Plant Elect. Only)
ltA6TER ELECTRIC C0. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation)
12467 BOONE AVE S.SAVAGE MN. 55378
�ignatu ontract , wn� rming In a iep) � �� Phone No.
�� 941 4?12/890-3555
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1A-11 8/� STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY