P - 80589REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board ot Electricity
1-380-320 � 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
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www. electricity. s ta te. mn. us
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Inspection Other Than qough-in: ea�y Now � Wil
Date ReaW'
1 certify that I am the � LICENSED CANTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecfion oi the electrical work at