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P - 80061+ REQUEST FOR ELECTRICAL INSPECTION Minnesota Board of Electricity - 1-382-151 %' 1821 University Avenue Suite 5�128, Saint Paul, Minnesota 55104 (661) 642-0600 TTYIMRS 1-600�627-3529 www.elecfncity.state.mn.us FOR OFFICE IISE ONLV Ilhlllalil�llill�lllllhlllhilll�flllllhl ��oD �,.�b Requast Date: Rough-in Inspection Requiretl? LJ Yes LJNO Inspec�ion Other Than Rough-in: LJ Featly Now LJ Will Call � �ro9�� you must call Ihe inspec�or wM1en reatly! Date Reatly: _ I cedity that I am the LICENSED COMfRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of ihe elecirical work at: Job AGtlress (SVeet, Box, or Rou�e No.) Ciry Zip Cotle 7847 FIRW006 WAY NE FRI�LEY 55432 Semion Township Range Fire No. COUmy ANOKA Occupant PM1one CAMERON SCOTT A C� r�;:,�.. Pourer Supplier Atldrefi9 XCELENERGY Electncal Con[raclor / Company Name Comracror License Number Mascer License Number HUNT EIECTRIC CbRPORATION CA dOB83 Mailing Atltlress (COn[rac�og Company or Qwner Pertortning Insialla�ian) 2300 TERRITORIAL ROAD , SAINT PAUL, MN 55114 Authorizetl Slgnature (Contracmq Gompeny or Owner Petlortning Installation) Phone 651 6�6-2811 EB-00001A-13 ]/i/2000 BOARD OF ELECTRICITV COPV INSTRUCTIONS ON BACK OF VELLOW COPY