P - 787841-4�2-319 �9
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity _;
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-08Q0 TTYIMRS 1-800-&27-35��yv�e(ectricity.state.mn.us
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Rough-inlnspection Required? ❑ Yes Ilnspection OtherTha
You must call the inspector when ready! Date Ready. �
�.�ecn enuTRar.Tr� f-1COMPANY ❑ OWNER and hereby
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of the electricai work at:
BOARD OF ELECTRICT' COPY