P - 81365III1111�II�IIII�II (III IIIIIIIIIIIIII 1^82�1UoiversaOR�aRmSRiPB,StPaPEMNION04 ���,
" 0 3 9 2 4 0 6 5* Pno�e �siz� sa2-osoo �+�
1ir Cond. Htg. Equip. Water Htr. X Load Mgmt. Other:
Jryer Range Elec. Heat emp. Service
above the work cove2d by this repues[ Enter remarks in this ;vace and on the back ot fhe whi[e copy only.
SAVEF?'S SWITCH 3NSTALLATiON
ulate fn;oection Fee - This /nspecUOn Fequest will not be acceptetl without ihe cwrect lee:
Other Fee n Service Entrance Size Fee +� Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps � I �0 to 100 Amps
Sheet Ltg./Traffic Sig. Above 200_Amps Above 100_Amps I
Trancfnrmer/Generatnr INSPELTORS USE ONLY TOTAL i
Xfmr.
S@
owim�plY��V�V H I hereDy cehlfy ihat I Inspcotetl ihe electrioal instellaGOr rlescribed herein on �he tlates stated
�fd93I100 BOOrtI� Pouqh-In Date
7t Special Inspection I. 50
Flnal oa�e
Irrvestigative Fee -
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request witl 18 mo hs fmm validatinr date pri�led in this box.
392-40�5] � �S 30
!a 6
JOH NUMBER #9$0600@
PLEASE PRINT OR TYPE
AeQUS;t �ayc 30 � gg RouSh-In Inspec0on repuiretl? 0 Yee o I ectlon Othar Than Fo Mn
0� r�sp ug '. d{ Reetly Now 0 WIII Czll
�YOU mus� call [M1e lnspector wM1en ready) Oate Reatly. 11 �'�� � cj�1�
I. � licensed wntrector ❑ owner hereby request inspection of the above elecirical work at
Jab Adtlress ISVeet Box, ar Route NoJ City Zip Gode
07110 F2IVERWOOD DR NE FRIDLEY 55432
Section No. Township Nam� or No. Range Na Fire No. Caunty
ANUKA
Occupan[ pMne No.
P:ENNETH A TIGUE 5'71-6102
Poxar 9upplier Atldress
NSP MPLS OFFICE
ElecVical Contractor (Compsny Name) ConVaUOr Llcenss No. Mester Lla Na (%ant EIecL Only)
MASTER ELECTRIC CO.,INC. CA01f92
Malling 4ddrese (C�nhacfor w Cwner Peri:nming InsteileYion)
12467 BQt7NE AVE S.SAVAGE MN. 55378
NNhonzsd SignaNre (Conhacror or Owner Performing Insiellation) Phone No_
712/850-3555
EB-000p1A-11 Bi95 STATE BOAftD COPV - SEE INSTRITG�fbN$4�iN BACK OF VELLOW COPV