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P - 79146
REQUEST FOR ELECTRICAL INSPECTION 1� 7 2 5- 4 6 5 7� Minnesota Board of Electricity - 1821 UniversityAvenue Suite S-128, Saint Paul, Minnesota 55104 '� (651) 642-0800 TTYlMRS 1-800-627-3529 www.electricity.state.mn.us � i��i �� ��� i� �i� «�� si ��! ii i« �� ��i ii ��i ����� 1 7 2'S 4 6 5 7 �i? � +�'_.._.. •zL':' ���—��� � R65�� �� ReQuest Date: Rcugh-in Inspection Required? Yes No I�pection Olher TT�en Raugh-In: OReady Now�7 WiU Call 12-8-04 You must call the inspector when ready! oec� r�aar . i ceAiy tt�at I am the �] LICENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request mspection of �e electricxFwork at: