P - 797251-�27-338 �
IOemiry �he work caveretl by iNS request:
❑NEW ❑REMO�EL ❑ADDITION
REQUEST FOR ELECTRICAL INSPECTION �
Minnesota Board of Electricity
1021 Universiry Avenue Su+te 5-128, Salnt Paul, Min�sota 55104 �:
(651) 642-0800 TTY/MRS 7-800 27�Q
www.elecd!'tCity.state.mlt.us ��Q � �
ONE 8 TWO FAMILV DWELLINGS, EACH UNIT
Includes ihe Service anNor Power Supply up ro 500 Amperes, All
CircuBs and Two Insoection Tnos Each Dwellino UnB �$84
�.t r-f- �F-/t -a6'
�he eleclnral
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FOq OFGICE USE ONLV
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Request Dafe: Rough-in Iwpection Requiretl? Ves
❑ ❑ No Inspedion Otlrer Than qough-In: eady Now � Will Call
/ You musl call the inspector when ready! Date Ready.
I certify ihat I am fhe �ICENSE� CONTRACTOR ❑ COMPANY ❑ OWNER arid hereby requesl inspection of Ne electrical work a[
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