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P - 75875
c REQUEST FOR ELECTRICAL INSPECTION 1�f3 ��— 9 5 5� Minnesota Board of Elechidty 1821 University Avenue Suite S-128, Sairrt Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-800-627-3529 www.e%tricity.state.mn.us N�a� ta��¢z;� ��� c�t�� �-< ������������������������������������� � . 160L9556 ���� ���� / Re�+ O�ta: Rough-in Inspacdon Requtred7 Y� ❑ No Uispectlon Ofh� Than Rough-1n: OReady Naw ❑ W�I Call '' � o You must cell the Inspeda wh ready! Date Ready. . I certify that I am Uie LICENSED CONTRACTOR ❑ CON�ANY ❑ OWNER and hereby request inspection of ihe etectrical work at: .� sne addre� lsuee�. eox ��rte nw.) cnr Da �e ,f /�041 /Uc� �!�//a5 �/'e�L� �� �2j��c, S3 7.j�-' S� ��� �—°1' ii,��y��`�'�.7��' : � �'�� � � �� � �> � �,e�g� ��1� � z l� �-7 ��z �'/o� encu aF reu.ow coPr eonRO ��ctwcm coav ee-0000�a-�a e.�. zooz