P - 79945� REQUEST FOR ELECTRICAL INSPECTION
1-17 3� L 4�J Minnesota eoard of Electricity
1821 Universi Avenue Suife 5-128, Saint Paul, Minnesota 55104
- (651) 642-OS00 TTY/MRS 1-SOOfi27-3529
t www.electriciry.srate.mn.us �
Itlentrfy ttie work covered 6y Ihis requesC /J ..O //Lrl B.a. J � ���
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❑NEW ❑REMODEL ❑AO�ITION R AIR _ ' / ✓'^� �
CIRCUITS
Indudes the Service anNOr Power Supply uD �0 500 Amperes, All
Cimuitc and Two Insoec[ion Trios Each Owellina Uni� �$Bf
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Requ/est Date: Rough-in IrepeIXion Requiretl? ❑ Yas Inspeclion Olher Than Rough-In: Nmv 0 Will Call
( � � You mus[celliheinspecbrwhen reaJy! Dflle Reatly:
I certiy ihat I am ihe �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the elecVical work at:
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