P - 79943REQUEST FOR ELECTRICAL WSPECTION � �
Minnesota Board of Electricity
1-�15 6- 6 6 8 18Z� University Avenua Suite S-128, Saint Paul, Minnesofa 55104
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❑REMODEL ❑ADDITION ❑REPAIR
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Inclutles Ihe Service anNor Power Supply up m 500 Amperes, All
Cimuitc antl Two Insoection Trios Each Dwellino Unit � SB(
(minimum toGi lee is
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Q� S Q You must cell ihe inspecta wM1en reeCy! Date Ready�
I cerliFj that I am the �LICENSE� COMRACTOR ❑ COMPANY ❑ OWNER and hereby reques[ inspedion o� the eledncal work at:
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