P - 79999.
� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-381-466 � 1821 University Avenue Suite 5�128, Saint Paul, Minnesota 55104
(651) 642-0600 TTYlMRS 1-800-627-3529
www.electricity.stafe. mn.us
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I certily that I am the [j LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at