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P - 83697, II��I�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII M8 �U� ae sa0 BeLR� SRIC8LSt PaPEMNION04 '����a, * * Phone (612) 642-0800 '�"'�''"` 03638996 Home Duplex Apt. Bldg. Other: New Addn Commercial Industrial Farm Remod Repair Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other: Dryer Range Elec. Heat Temp. Service "X" above the work covered by this request. Enter remarks in this space and on ihe back of the white copy only. SAVER'S SWiTCH INSTALLATION Calculate Inspection Fee - This Inspection 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 Sig. Above 200_Amps Above 100 Amps Transformer/Generator INSPECTOR'S USE ONLV TOTAL � Sign/Outline Ltg. Xfmr. 15. Alarm/Remote Control Swimming Pool I hereby certify that I inspected the electrical installation described herein on the dates stated Irrigation Boom Rough-In Date }t Special Inspe tion i. 00 Final Da►e^ � Investigative "" .0 � % — THIS INSTALLATION MA E ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS. OFFICE USE ONLY This request void 18 months from validation date printed in this box. 363-899 �] � � � � �S,Sa � JOB NUMBER �9706000 PLEASE PRINT OR TYPE rtequest-yoajel-� � y� Rough-in inspection required? ❑ Yes �(Jo Inspection Other Than Rough-In: � (You must call the inspector when ready) Date Ready: I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at: Job Address (Street, Box, or Route No.) Cit 01621 OHONDAGA ST NE F�tIDLEY Section No. Township Name or No. Range No. Fire No. County ANOKA Occupant Phone No. F MILLIAK OLSEN Power Supplier Address NSP MPLS OF'FICE Electrical Contractor (Company Name) Contractor License No. MASTER ELECTRIC C0. INC. CA01192 Mailing Address (Contractor or Owner Performing Installation) 12467 $OONE AVE S. SAVAGE ![N_ 55378 or Owner Performing Installation) Ready Now ❑ Will Call 7/17/97 Zip Code 55432 786-3990 11 S/95 STATE BOARD COPY - SEE INSTRECTJONS ON BACK OF YELLOW COPY Master Lic. No. (Plant Elect. Only) Phone No.