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P - 80197. REQUEST FOR ELECTRICAL INSPECTION 1 ��� ��� Minnesota Board of Electricity � � � 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104 ' y'� (651) 642-OS00 TTY/MRS 7�800�27-3529 . I www.etectriciry.state.mn.us I �NEW ❑REMODEL ❑ADDITION ❑REPAIR r� InGudes the Sernce anNOr Power Supply up to 500 total fee is All Ipecial Irepection �$.31 perMile C, g�/%°i I iHIS INSTALLATION MAY. BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS � FOR OFFICE USE ONLY llllllf!{{IN{Nil11{{IIIIIlIfIIIIINII{NIl{INII ii 1 1 9 4 6 7 7 9 7E /,; � ��s� � ' �� / - d I cedify Ma[ I am the � ��-- ee-r000�n-i3 �nrzooa �3 � Rough-in Inspeqion Requiretl? ❑ Y¢s Inspectian plher Than Rough-in: ady Now � WII Cell Vou musf call ihe inspector w�m reatlyl Date ReaRy: �I ENSED CONTRACTOR ❑ COMPANY ❑ OWNER and here6y request insped'ron of ihe eledrical work at: or Route NoJ ity zp p � �'a r� �G �/I'' .�S �3d- Renge Fire No. Counry �`� /� �C� o� � .+!/ %�. Pertorming ' ;/ Phone j_ ?/�! / !/ LJ � J ` Dn���� � or License Number Master License Num ��/ C �� ��� Phoire y 3��53 :�n cOVV llsinucTroNS oN e