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P - 80203REQUEST FOR ELECTRICAL INSPECTION ,� Minnesota Board of Elearicity 1� 0� 3 5- 5 9 7 # 1821 Universiry Avenue Sui[e S-128, Saint Paul, Minnesota 55104 � ,�v �ssi) sa2-oaoo mmaas �-soo-sz�-ssxs , Hnvw.elecrncary.state.mn.us FOR OFFICE USE ONLY { NII{Iff11111111lIlil{IINIIIICI!{{ll{Illllillll _ �t i O 3 5 5 9 7 2�t /'. �p y�� i �� Request Date: �/� flough-in Inspeclian Requiretl? ❑ Ves o Inspectlon OMer Than RougMln: eatly Now 0 Will Lall I� �—✓/ Vw mvst call ihe inspector when reatly! Oate Reatly. I certify ihat I am the �ICENSEO C�NTRACTOR ❑ C00,1PANY ❑ OWNER aiM hereby request mspection of ine electrical work at: li .b0 Atltl�e55 (tlVBe( tlOx, o� RW[2 No.) Cdy Zlp CotlB �S! OVC-2��'drv 2tt/�. �2,t,D SSY3 � SeCion Tmvnsfiip � l� �., p� Raige Fre No. C/o]unry � /v V ti i�l`�Q''ft ��ST�v�rJ B�K.� P763 -S�t - o �/?45� 2 FB-0W01R.13 ]/1f2ppp Icanse Number 02� `� �/ab—b0ab � INSTflUCTIOHS ON BPCK OF YELLOW LOPV