The URL can be used to link to this page

P - 78922c REQUEST FOR ELECTRICAL INSPECTION � 1� V�� a 7 61 �8 Minnesota Board of Electricity .— -''R"' 1821 University Avenue Suite S-128, Sairrt Paul, Minnesota 55104 ' (651) 642-0800 TlY/MRS 1-800�27-3529 www.electriciry.state.nen.us ❑ NEW ❑ REMOD�L ❑ ADDITION ❑ REPAIR Describe -using the bxl�of the white copy rf necessary - the wak covered by this request: � " . t,i.�r • ; ,\,_.... .. ^r . . . . _ . . . .. .. _ . GRCUITS OF LESS THAN 50 VOLTS 3 to 12 Units � S50 Per Each Additional Unit � ; KVA ONE 8 TWO FAMILY DWELLINGS, EACH UNIT Includes the Service and/or Power Supply up to 500 Amperes, All Circui�s and Two Inspection Trips Each Dwelling Unit @ t8p (minimum totai fee is $20) � �1� xJ. TWS�REAFORP6PECTORUSEOKY � � �122bi � 1� � I�SplC� d1E E�IC3� �IISi��2b011 �$CII� �NI Ofl d1E � S�: y� . . . .. - —' �v � GI `V�� `y{rV�C��\� ys,'.� . ��.-�. }� � � __._.—.��— / ! v Vtl IIIII �IIII III�I IIII� III�� III�� II�II IIIII �� I� 1 6 2 7 7 6 1 8 ReQ�st Date: Rpughin Inspectlqi ►teqwred? Yes N �, � I / �� +r YOU muSt CeU 1hC insPedOr when reedy� " � cerMy that I am U�e ❑ LICENSED CONTRACT .►ob 5de Address (� Box. a � °� ,,.c ,�1�'{e . ,� �'!l� ��'�$�i J�� {��.i' � y/�j �od�� 0��3 OR ❑ COMPANY ❑ OWNER end herebY recluest inspection of the electrical wak at: No.) Zip Qode ��ta-� � �� 6�.� -� �' � ,' ��i.. �� Q �=e � , � La�'�/'t_�$. � fi �� e Aowae Two �s� Php� wmner(�) u 14fY�v�,�'��/ �� / plier Address �e^s° N�e► INesEar eclA�danQ a Pow � ! � Va��Num�,/ � s._.:__. �-2�/�,% � .�fi:/ �' - ��uro�s� '�" � ��-�--� -� ��a �a-6�7 is,RUC�s�„��u.owcbw -�•� �63 le�3Sr �ya-� e�o oF �c�wcm coav . E&OOODIMI� ��. 8.1.2002