P - 76145REQUEST FOR ELECTRICAL INSPECTION
1- 7 3 3- 4 8 8� Minn�ta Board of Electriaiy
1821 Urriversily Avenue Suite 5-128, Sairrt Pattl, Minnesota 55104
(851) 842-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
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I certify tliat I am the CENSED CONTRACTOR ❑ COW�ANY ❑ OWNER and herebr iequest inspection oF tlte electrical xrork at:
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