P - 75903REQUEST FOR ELECTRICAL INSPECTION "`° �
1� 9��� 5 31 � Minnesota Board of Electricity
+. 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 -
�` (659)642-OS00'1�'Y/MRS1-800-627-3529www.electricity.state.mn.us
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/ Rough-in Inspedion Required7 ❑ Yes �No Insp�lian Ofher Then Rough-In: ❑ Ready Now ❑ WW Ca0
� You must call the inspector when ready! Date Ready. /V O�i"
I ceitify that I am the ❑ LICENSED CONTR�4CTOR ❑ COMPANY p OWNER and hereby request inspection of the electrical work at