Loading...
P - 83679I IIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII M8 �n Uo a SsatOe BeLRof SRecCt$cS{NP PEMNIONoa ���,,,��. � 'i`' 4 4 * Phone (612) 642-0800 �`'�'""" 036325 Home Duplex Apt. Bldg. Other: New Addn Commerciai Industrial Farm Remod Repair Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other: Dryer Range Elec. Heat Temp. Service "X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only. SAVER'S SWITCH INSTALLATION Calculafe In�ection Fee - This Inspection Request will noi be accepted without the correcf 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 TOTALS � 1 Sign/Outline Ltg. Xfmr. Alarm/Remote Control Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated Irrigation Boom Rough-In oate Special Inspection Date Final Investigative Fee "' �' �"��` '"S THIS INSTALLA N"M � RDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS. � � �! �~ OFFICE USE ONLY This request void 18 months from validation date printed in this box. 363-254 �] e .� �� 8 0 � f��s JOB HUMBER �l9706000 PLEASE PRINT OR TYPE Request Rough-in inspection required? ❑ Yes o Inspection Other Than Rough-In: Ready Now ❑ Will Call (You must call the inspector when ready) Date Ready: /� 1%� 9% I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at: Job Address (Street, Box, or Route No.) Cit Zip Code 00646 KIMBALL ST NE F�2IDLEY 55432 Section No. Township Name or No. Range No. Fire No. County ANOKA Occupant Phone No. LA VONNE BROBERG 784-8084 Power Supplier Address NSP MPLS OF'FICE Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only) ![ASTER ELECTRIC CO. , INC. CA01192 Mailing Address (Contractor or Owner Performing Installation) I 12467 BOONE AVB S. SAVAGE NN. 55378 Author Signat e ontract Owner Performing Installation) Phone No. I, , �% 941 4712/890-3555 � � E-00001A-11 8/95 STATE BOARD COPY - SEE IMSTRUCTIONS ON BACK OF YELLOW COPY —