P - 80606REQUEST FOR ELECTRICAL INSPECTION .
1 111 8 g 4 Minnesota Board of Electncity �°"'�
� � 1821 Univereiry Avenue Suite 5-728, Saint Paul, Minnesota 55104
_. (657) 642-0800 TTY/MRS 1-800-627-3529 �
www.electriciry_state.mn.us �S ':�. .
iuerrtiry me work cmerea oy inis requese '�7 �+ //)
❑NEW ❑REMODEL ❑ADDITION ❑PEPAIR ' `� ��`� V'�" v�� � "�
Includes Ne Service anNa Power Suppty up ro 500 Amperes, All
FOA �FfICE USE WIIY
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I certiry ihat I am
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_� You must caX tlie Inspacror when reaEyl � �ate
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antl hereby request inspection ot the elecirical vrork at: �
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