P - 79010REQUEST FOR ELECTRICAL INSPECTION
1-� ���� 1 a� � Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
��� S 7� Q (651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.rrtn.us
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Reauesc Date: Rougn�o �nspecfion Reyuired? ves �nspectim onier rnan Rcwgn-In: �Rseay MaMr ca��
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I certHy tl�at I am ihe �f.ICENSED CONTRACTOR ❑COMIPANY ❑ OWNER and heieby request inspection of ihe electrical work at:
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