P - 79420� REQUEST POR ELECTRICAL INSPECTION ,��,
�j Q7 �+ Minnesota Board of Electriciry
� 1=16 6� O 1 O 1821 Univereity Avenue Suite 5428, Saint Paul, Minnesota 55104 s�
� �ssi� saz-oeoo TTY/MRS 1-804627-3529
www.elec[riciry.siate.rrza.us
IAentrfy Me work coveretl by tM1is request e�. /� �u ,� �� /�p�, � 3,c,�n' ��
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❑NEW ❑REMODEL ❑ADDRION ❑REPAIR �j,�r�pd/ ,S'�L�/^'h '{'��i
Tf3fI5�ORIlEIS OV¢f 10 KVH � JLU
Tra�brmer I Power Supply tor Signs / Outline LigMing � 35
ONE & TWO FAMILY DWELLINGS, EACH UNIT
InGu9es \he Semce anNa� Powet Supply up to 50� Amperes, AA
f,irr.uik aM Two Insoec�ion Tfi05 Eadt DWelling Unit �$81
Special InsO��on �$30 per Hour � I�++`NSPEm�o. �
$oecNl InwecMion � 531 Per M'le / � � �
� THIS MSTALLATION MAY BE ORDERED DISCONNE N07 COMPLE7ED WITHIN 78 MONTHS
FOR OFFICE USE ONLY
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� Vou must call ihe inspector w�en reatly! Date Peatly: Z. J
'LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER antl he by request inspection oi the electrical work at:
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