P - 79375REQUEST FOR ELECTRICAL INSPECTION
*¢���, Minnesota Board of Electricity �"°`
j. � 3 2 3- 6 6 4 1821 Universiry Avenue Suite 5-128, Saint Paul, Minnesota 55104
�ssi� saz-oeoa TTY/MRS 1-800-627-3529
www.eieciriciry.staie.mrt.us
I cetlity that I am the�LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electncal work at