P - 79262REQUEST FOR ELECTRICAL WSPECTION ��
1 3 21 � 4 7 ° Minnesota Board of Electricity
� � "* 782t University Avenue Suite 5-128, Saint Paul, Minnesota 55704
-**��� (651)642-0800 TTV/MR51-800-6273529 ���
www. elecdriciry. sdate.mn. us
Itlen[ity ihe woM coveretl by this �equest: / %�C .
❑NEW ❑REMODEL ❑AODITION HREPAIR �LL���� � "� � `
Includes the Sernce anNOr Pmver Supply up to 500 Amperes, All
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toial fee is
on tne dates staretl:
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cetliy ihat I am ihe �{ENSED CONTRACTOR ❑ COMPANY '
❑ OWNER and hereby reques� inspection of fhe electncal work ah
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BO�R� OF ELECTqltrty COPY
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