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P - 75140
�` v� `� �� iV �,.� . � u.�From: 9529845952 Paqe:�2/2 J� Date: 9/5/2007 8:19:27 AM �v` ��, � .`` RAinrtesofa rtrnent of Labor �d lr�dusyr �� �� p �j 2007 A43 L�y '� oad North � '� ��.� �GG7—Dl(�6� 1TY/MR3 (651) 287-4198 Homeowner R uest for Rqugh-In {n�or1 RBquiretl7 Yes ifort�eowner M ule ! R h-In I� ans en — .^�tr�t�} t!F I � 1Lc�.`� �i I�G �. IV �r�C�- ---�1nrv4. 9r e{ephone Numi�r(s) — Include A►ga zi,3 �7'�Z� �s"�(r? 9r MalU�ng �ddr�ss — S'tre6t ► `� 1 �...u.� �,�-�.i� Re�dy I�►► MV'itl Sr�lu • �*� i it, � � , .,. . � ; � / � � �, 1 (�r�'� hu�,� �S r �o� I ihis documer►t, I certify tttat I am the Owner 83 de�irsed by Minn. S't8t § 328.01 and vrill IYew Horrre ar 1lssoci�d Sbrur,#u�a New li� Seroloa/POwBt SuPp�► 0— 40Q amPer� �$a5 _- Naw Home Serv�JPoa►eu' Suppty 401— 800 ¢�mPe�o �! $�0 IVe�v Homo Fe�ts►Cirouits up � 30 Feed�m�fCiRx�its -.$ luswr 1�1�„en _ � h�en 3e F�d.�alctrh,;ra nn �1d iHen te N ���� Fe� Calculat�ion Ex��ing HornelStructur� R�n�del of Addit�an New servic�/Pov�r s�pty o— aoo ampe�e ��is I�w Sc�rvk�etPc�wBr Supplr 4p1 �- 800 ampere ��8Q — Ne��d F�sJCU►srit� — Ue te 15 Feed�r9/CiraiHs Det�ached Ga�age ar 011ter A�i�d berucivre N�3w SBrvi�aa�ar Supgy 0— 4� amp�e �',&35 New �88d�BICi�ufts ( ) � S8 Each Oei�cfred t�lage O� O�ter A�soaial� Sduat�ure New Serv�Po�er Sup�r Q— 400 empere �► S35 NervlExEer�dBd FesdBrs/Cirarfia i ) � $'9 F.arh Raa��d Feedere/Cit�uifs ( ) � $�! Eadt � T�1(Ftre ti�e aatauia�d abo� ar S35 mu�Alied T�1(tfro � calcutaEed �oMe of�utcip� r� bp tl�e number ai required �on d�� � by #!►e numh8r of naquinad +�sPe�ia� hi�. G�'iV whir�ever ts g�eatery r, wi►tc�ever � g�ea�er) �-�-'" . � Raq� for ElsctrkN InspaeUon (Rp} whh s(� at i9�0 or fass axpke 1� ma�s trom tha fiTh1g date. The owner mus� hars !he �rork �pt�bd tho 1Z monM pe�iad or aubmit �ro#�her F�1 tl� faaludes t11a I�ape#lon (M fa� tlre �oseonfpla2�rd w�m16 �naPaation t�es do eroR wrf► ov� ham ab t�l to or�ar. A�rv149 OP S30 vvAl bB �ldded foT eli led Ghscks. I i�r aertify tFaat I U�e elerfiicaf herain an the � st�ad: Far E1Ap�m��t Us� OnIY Rnugh � !n tnspecdoa�(s) Date a� � ��'�D I �I� �n t inrn�. auah � la� arint, Brallle or on a TDD (681� �'i�7�. F� oi tero7y oi