P - 80051REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of ElectricAy
1-382-149 �� 1621 lJniversity Avenue Suite 5-126, Saint Paul, Minnesola 55104
(651) 642-0800 TTYIMRS 1-800-6273529
www.electricity.sfate.mn. us
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I cedify ihat I am ihe C1 LICENSED CONiRACTOR ❑ COMPANY ❑ OWNER � and hereby request inspection ot ihe eledriral work at: