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* 0 3 6 3 9 4 0 8* Phone(612)642-0800
Home Duplex Apt. Bldg. Other: New
Commercial Industrial Farm Remod
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 of the white copy only.
SAVER'S SWITCH INSTALLATION
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Addn
;alculate Inspection Fee - This Inspection Request will not be accepted without the correct fee:
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 TOTAL
Sign/Outline Ltg. Xfmr. 15.
Alarm/Remote Control
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
Speciallnsp i
Final te �/
Investigative C�1 �' d
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 18 months from validation date printed in this box.
363-940� �o
/�� � '� � �
JOB NUMBER �l9706000
PLEASE PRINT OR TYPE
Request�aj�l � Rough-in inspection required? ❑ Yes o Inspection Other Than Rough-In: � Ready Now ❑ Will Call
(You must call the inspector when ready) Date Ready: %�,1 %� 9%
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No. Cit Zip Code
00740 BENN�TT DR HE F�tIDLEY 55432
Section No. Township Name or No. Range No. Fire No. County
AHOKA
Occupant Phone No.
FRANK SCZEPANSKI 572-0641
Power Supplier Address
NSP MPLS OF'F'ICE
Electrical Contractor (Company Name) Contractor License No. Master Lia No. (Plant Elect. Only)
liASTER ELECTRIC CO. , INC. CA01192
Mailing Address (Contractor or Owner Performing Installation) I
12467 �OONE AVE S.SAVAGE l�N. 55378 '
Aut ed Sign ure (Co r r or O ner Performing�lnstallation) Phone No.
941 4712
EB-00001A-11 8/95 STATE BOARO COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY