Loading...
P - 812985 �2-573 Calcufo�e Inspection Fee - This Insp� Other Fee Mo6ile Home Park Stall Street Ltp./TmHic Sia. �e Ltg. xhnr. io�e Conlrol Pool RE�UEST FOR ELECTRICAL INSPECTION •. Min�sota State Board of Electricity 1821 University Ave., Rm. 5-728, St. Paul, MN 55104 Phone (612) 642-0800. �' e, Elec. Heat Temp. $ervice 7WI�ry1N� 0�QL requesf. Enter remarks in fhis spare ond on fhe back of ihe whiYe copy c cfion Requesf wil! no� be accepfed witboW the corretf Fee: N Service Entrance Size Fee M Circuits/Feeders 0 to 200 Amps O l0 10( Above 200—Amps Above 1 INSPECTOfl'S USE ONLY ,�{(a {�w.s L, /G'����br 5 Gv.Gtie�� herebr cenilv tha� I I�saecred �he elxtriml insmllation deunbed he �he ��� THIS INSTALLAiION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS. � OfACE USE ONLV ihis reque4void 78 mwnhs hom wlidation dole primed in �his box. (II�II�II�IIIIII II�II��I�IIIIIIIIII �� �.�.1 � a7�9 * 0 5 3 2 5 7 3 3* P�EASE PRINT OR TYPE �9 �� Raryl.�� i�specnon reqairad¢ ❑ Yes ❑ Na Inzpeciion OiMr Tho� RoigMn: ❑ Ready Now ill Call �� 3^�� (Vnu must wll tha i�spector when reudy) �a�e keady. I, ❑ licensed contmc�or�owner hereby request inspecfion of fhe above electrical work at bbAddreu�5heet 8o a Rou No) Ctly ��,�, ZiP�ode��� � �s1.� �,ri�,c'�? ST �v�' r��jr ss We�. Nn T�.w�.hle Nnmw nr Nn Ranae Na Fire No. CwnN _ . w o«�,w��/C�/'07�G Power SuPPiier � `� S Ph No. G e�'G/10 ��5�4-2/ i'S .�w - �,�, �,�. STATE 80ARU CAPY - SEE lNSTIiUCTONS ON BACK OF YELLOW COPY