P - 83060I tIf91� �If IIIII Ifllf f�lll �Iflf II�I1 IIIiI tlll ilfl M8 Q�U° ae saO B e R� SR 1 8 StN SPEnCN ION04 ����`
� * 0 3$ 6 9 3 8 5'� Phone (612) 642-0800 �'����
Home Dup�ex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. oad Mgmt. Other:
Dryer Range Elec. Heat emp. Service
"X" above the work cove�ed by this requesf. Enter remarks in this space and on the back of the white cqoy only.
SAVER'S SWITCH INSTALLATIOH
Calculate Inspection Fee - This Inspection Request will not be accepted without the cwrect fee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTAL 15. $0
Sign/Outline Ltg. Xfmr.
Alarm/Remote C
Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated
Irrigation Boom Rough-In Date
peciallnspection '
Fi�al ate
Investigative Fee ^ Z —
THIS INSTALLATION MAY BE ORDERED DIS ECTED IF NOT COMPLETED W HIN 18 MONTHS.
386�V V� OFFiCE USE ONLY This request void 18 m�from validation date printed in this box.
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JOB NUMBER �970�600
PLEASE PRINT OR TYPE
Request Da . Rough-in inspection required? ❑ Yes ❑ N Inspection Other Than Rough-In: ❑ dy Now ❑ Will Call
(You must call the inspector when ready) Date Ready: 8� 14 I 98
I, ❑ licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job P���9lr�t, Box, or R� r•�I V ER RD c'tYF'R I DLEY zip c°�5432
0
Section No. Township Name or No. Range No. Fire No. County AHOKA
�`�'P�tICHARD F GATES Pno�e No. 572-1622
Power Supplier Address
NSP MPLS OFFICE
Electrical Contractor (Comparry Name) Contractor License No. Master Lic. No. (Plant Elect. Ony)
C[A�TER ELECTRIC CO. , INC. CA01192
Mailing Address (Contractor or Owner Perfwming Installation)
124fi7 BOONE AVE S. SAVAGE MN. 55378
Authorized Signa� � ntractor or Owner Perfaming Installation) - � PFwne No.
. �r` 94 —4712/890-355
E&00001A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY