P - 77585REQUEST FOR ELECTRICAL INSPECTION �
1�`U 1�- 2� 9� Minnesota Board of Electriaty p2�- �/j�� •
1821 University Avenue Suite S-128, Sairrt Paul. Minnesota 55104
� • (651) 642-0800 TTY/MRS 1-800-627-3529 www.e[ectriciry.state.mn.us
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Request Dale: Roughin Inspection Required? Yes ❑ No Inspecfion Olf�er Than Rough-In: �Ready Now � WNI Call
� $ S You must call Vie inspector when ready! Date Ready:
1 oertify ttiat I am the'�l�ENSED CONTRACTOR ❑ COMPANY ❑ OYVNER and hereby request inspection of the electric�l wak at:
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