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P - 79085c(� REQUEST FOR ELECTRICAL INSPECTION 1� V� V-� 7 3� Minnesota Board of Electricity - 1821 University Avenue Suite S-128, SaiM Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us Q�t y��t. ,sr ort� t' jj N �--�` /✓ / . � IIII) IIIII II�II IIIII �I�II III�I IIIII �IIII II� I� C!z /0/9� 1 6 1 0 8 7 3 0 �� ` C�'1� l �� ReQuest �te: Rough-in Inspection Required4 ❑ Yes No Inspection Olher Than Rough-M: �7Ready Nav ❑ Wil C�I 5/�/ Yau m�t call the inspecta when readY� Dete Ready. I certify that I am 1he [�ICENSED CONTRACTOR 0 COMPANY ❑ OWNER and hereby request inspection oF 1he electrical wak at: Job Site Address (Street. Bw4 or Route No.) (a�y ��8 748 Nlississinni Str�at �,-;,�ie., ��.�-, Walter AriO1Ca (76� 571-3079( ) ...,...,,o., ..�,,.� �,�. � �� ► �� « Robbinsdale Electric `'°�'�` "'"ibef .� � cc�. c�o�r «o�,� v CA01549 �erto��oe ms�auon) 37�$ West Broadway Robbinsdale NIl�T 55422 aF r�t�eow caw '� eou�o oF �cnticm coav ee-0000t�-u e.t. zooi