P - 79415REQUEST FOR ELECTRICAL INSPECTION
:� 2 6 8 5 Minnesota Board of Electricity °r
1�' � 1821 University Avenue Suite 5-128. Saint Paul, Minnesota 55104
�` _ (651) 642-0800 TTYlMRS i-800-627-3529 - . -
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www.electriciry.state.mn.us `�^�-�
❑ADDITION ❑HEPAIR �
CfRCUITS OF LESS THAN 50 VOLTS
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Includes ihe Service anNor Pmver Supply up to 500 Amperes, All
CircuiLS antl Two Insoection Trios Each Dwellina Unit �$8(
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total fee is
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I certly lhat t am t�ENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby reques[ inspedion M the eleclrical work at:
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