P - 80617REQUEST FOR ELECTRICAL INSPECTION -
��� O ��� Minnesota Board of Electricity ���
� � 1621 Universrty Avenue Suite 5-128, Saint Paul, Minnesoia 55104
��� -i-*�-{� (651) 642-0800 TTYIMRS 1-800-6273529
www.electriciry.state.mn.us '�
Itlenlify the work cAVe2tl �y thii request '' � S a ll 1O C� Gt � e� '�� .
� Transfortner I Power Supply Sor Signs ! ONline LigMing �$5
ONE & TWO FAMILY DWELLINGS. EACH UNIT
Includes ihe Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Insoeclion Tnos Each D�velling Unit �$8C
� l— FOfl OFFICE USE ONLY
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I ceNfy that I am ihe �I LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and here6y request inspection of the elechical urork at:
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