P - 79386r_ RE�UEST FOR ELECTRICAL INSPECTION
" 1��� o� U O� : Minnesota Board of Electricity ��
� 7821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 ��
'"�' (657) 642-0800 TTYlMRS 1-B00-627-3529 �
;� �L���� www.electncity.state.mn.us �
I A�1M, COMMUNICATION, REMOTE
REPAIR
VOLTS
J��— %% % �- %�i�.5
ONE 8 TWO FAMIIY OWELLINGS, EACH UNtT
Includes ihe Service anNor Power Suppty up to 500 Ampe2s, All
CircuAS antl Two Insoection TnPS Each Dwellino Unit �£81
total fee is
S INSTALLA7IVIV MAY BE OflDERED DISCONNEGTED IF NOT COMPLETE� WITHIN 18 MONTHS
__ v FOR OFFICE USE ONLY . t�. f� j.�% ,—
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I,U �/�' + Vou must call ihe inspec�or when reatly! I Da�e
I certify ihat I am ihe �LICENSED CONTRACTOR ❑ COMPANY ❑ ONRJER
Job Atltlress Btreet. Bon w Route No.f Ciw
Occupam �.,/
nrriio� �`�
Center Point Energy MGCO
13562 Central Ave NE
Anoka, MN 55304 +er
Ottie� fhen Hough-In: U Featly Now �PII Call I
'Y:
and hereby request inspectbn of the eledrical work at:
Zip SCo`tle!,
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I.iwnse Number
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