P - 79972REQUEST FOR ELECTRICAL INSPECTION
1 i 9 0 6 21 Minnesota Board of Electriciry �
� � 1827 Universiry Avenue Suite 5-128, Sain[ Paul, Minnesota 55104
. �. ��- (651) 642-0800 TTV/MflS 1-800-627-3529 �
- www.electricity.state.mn.us �,�(�
I I �NEW J�¢iEMO�EL ❑ADDITION ❑REPAIR
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Inclutles the Service anNa Power Supply up ro WO Amperes, All
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I cetlity ihat I am ihe�CENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electricaf work at
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