P - 80585, REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-3$0-316 � 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTYlMRS 1-800-627-3529
www.electricity.state.mn. us
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I certity ihat I am the L� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and here6y request inspecUOn of ihe electrical work at: