P - 825831'°� 14-556 0 REQUEST FOR ELECTRICAL INSPECTION ���-Ee
- Minnesota State Board of Electricity �ti;- , 3
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104-2993 - ."�
' (651) 642-0800 www.electricity.state.mn.us �''
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Y Home Duplex Apt. Bldg. Other: New Atldn
Commercial Intlustrial Farm Remod Repair
Air Contlitioner Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elect. Heat Temp. Service
'X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only.
NSP SAVER'S SWITCH
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Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee.
Other Installations Fee # Service Entrance Size Fee # Circuits / Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg. / Traffic Sig. Above 200 Amps Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTAL
Sign / Outline Ltg. Xfmr. �,�jQ
Alarm/Remote Control
Swimming Pool
I hereby certity that I inspected the electrical installation described herein on the dates stated:
Irrigation Boom Rough In Date
Special Inspection
Final �' p � /
Investigative Fee �-- ,�
. THIS INSTALLATION MAY BE ORDERED DISC NECTED IF NOT COMPLETED WITHIN 18 MONTHS.
_ - . .............,.............................,.......,....,,..,,......_ ........................_ .............................................................. .........
I IIIIII I�I(I IIIII IIIII IIIII II IIII� IIII IIII OFFICE USE ONLY This request void 18 months from validation date printed in this box.
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PLEASE PRINT OR TYPE I
Request Date �
Rough-In inspection required? � Yes � No� Inspection Other Than Rough-In: Ready Now ❑ Will Call
�u�' �� iS� You must call the inspector when ready! Date Ready:
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I, [�icensed contractor ❑ company ❑ owner hereby request inspection of the above electrical work at:
Job Address (Street, Box, or Route No.) �iry Zip Code:
6490 �T�NSON BLY FRtQLEY 55432
Section No. Township Name or No. Range No. Fire No. County
----- --- ---------------------- AN9KA
Occupant
SCHNEIDER DENNiS L Phone No.
Power Supplier Address
NSP
Electrical Contractor / Company Name Contractor License No. Master Lic. No. (Plant Elect. Only)
HUNT ELECTRt� CORPC7RATI�N CR ppgg3
Mailing Address (Contractor, Company or Owner Performing Installation)
?3�} TERRITORIA.L ROP,D , SAIIdT PAUL, R�IId 55114
Authorized Signature (Contract� pany or Owner Performing Installation)
t`,+ Phone Number
� � B5� 84�--2311
EB-00001A-12 5/1999 STATE BOARD COPY SEE INSTRUCTIONS ON BACK OF YELLOW COPY