P - 78863REQUEST FOR ELECTRICAL INSPECTION
1����- 3 0 9 �e Minnesota Board of Electriciry
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
- � ��a� (651) 642-0800 TTY/MRS 1-800-627-3529 - _
www. electricity. state. mn. us
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, You must call the inspector when ready� Date Read 3 0'�
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I certTy �at I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER --••--
and hereby
inspection of the electrical work at:
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�NSTRUCTIONS ON BACK OF YELLOW COPV