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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. ����������������II�I�� i�l �� �� � ��" .�'� I�����II��� *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 ^ . :0 1 A-1 1 8/96 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPv Only) 786-8484