P - 78131REQUEST FOR ELECTRICAL INSPECTION
1����- 2 9 7� Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Sairrt Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
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Request Date: Rough�n Inspedion Required? ❑ Y No Irupedion Ofhex Th� Rough-In: �Ready Now 0 WNI Call
You musl call the inspecta when ready! pete Ready
I certi(y lhat I am U�e -�CICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of ihe electric�al work at:
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