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�� REQUEST FOR ELEC� RICAL ILV�S,EC�� N�
1 ��./ I� �� g 7 � Minnesota Board of Electria G\� Gj �
1821 University Avenue Suite S-128, SaiM Paul, Minnes�a Y6
(651)642-080011Y/MRS 1-800�27-3529 www.electricity.state.mn.us
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��Rough-in Inspection Required? ❑ Yes ��•Ao Inspedion Otlier Th� Raugh-In: f�eady Now ❑ Will Call
You must call the inspeelor wAen readyf 1/\ Date Ready .
I that I am tlie ICENSED CONTRACTOR ❑COMPANY ❑ OVNVER and hereby request inspection of tl�e electrical work at:
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