P - 81486REQUEST FOR ELECTRICAL INSPECTION
.?�y 7���� m Minnesota State Board of Electricity
J 1 1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone(612)642-0800
Home Duplex
Commercial Industria
"X" above the
Farm
Water Htr. Load Mgmt. Other:
Elec. Heat Temp. Service
this request. Enier remarks in this space and on
New
Remod
of the white copy only.
Calculate Inspection Fee - This Inspeciion Request will not be accepted without the correct 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 $ig. Above 200 Am s Above 100 Amps
Transformer/Generator INSPECTOR•S use ON�v TOTAL 15 . 50
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pool
I hereb certi fhat I ins ted fhe electrical installation described herein on ihe dates stated
Irrigation Boom RougM� pa�
Special Insp
Finol - ����
Investigative � —
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTH .
_ OFFICE USE ONLY This request void 18 monfhs from validation date printed in fhis box.
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*07379126* /063
PLEASE PRINT OR TYPE
Request Date 3-4-99 Rough-in inspection required? ❑ Yes � No Ins ction Ofher Than Rou h-In:
pe g � Ready Now � Will Call
�You must call fhe inspector when ready) Date Ready:
I, [�licensed contractor ❑ owner hereby request inspection of the above electrical work at:
Job Address �Skeef, Box, or Route No.) City Zip Code
7560 McKinley Fridley 55432
Secfion No. Township Name or No. Range No. fire No. County
Occupanf
Duane Kloncz
Phone No.
784-2041
:lecfrical Contracfor �Company Name� Confractor License No. Master Lic
Total Electric Inc. CA02749
+lailing Address �Contractor or Owner Performing Installation)
10760 ankato St NE Suite 1 Blaine MN '4
!ufhoriz na e(Conhacfor or Owner rmin Ins f' Phone No.
-�a
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:0 1 A-1 1 8/96 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPv
Only)
786-8484