P - 79392REQUEST FOR ELECTRICAL INSPECTION ��
1 2 3 7 3 2 2 ¢� Mmnesota Board of Electricity
!� � � 1821 Universiry Avenue Suite 5428, Saint Paul, Minnesota 55104
'E (651) 642-OS00 TTY/MRS 1-500-627-3529
www.electriciry.state.mn.us !�
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THAN 50
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Inclutles ihe Service anNor Power Supply up to 500 Amperes, 0.11
Cireuits and Two Inspection Trips Each Dwelling Unit � 38C
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total fee is S2�) j"�E
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FOR OFFICE USE ONLY
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Request Date: Rough-in Inspeclion Requiretl? ❑ yes ❑ No Inspaction Other Than Rough-In: ❑ Ready Now W�II Call
' Vou muat call tlie inspector when reaEyl Date Reatly:
I cenity ihat I am ihe LICENSED CONiRACTOR ❑ COMPANY ❑ OYVNER and hereby requesi inspection of the electrical xiork at
Job Atltlress ($ireet, Box, or Route No.) Ciry Zip Cotle
1538 Trollhaqen Drive N. , Fric3lev 55421
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Scott
PawerSuoulier
Electric Metro
(COntraclor, Company or Owner Perl
Anoka
Pnon763-574-968
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OF ELECTpIGTY COPY INSIPUCIIONS ON BACN OF YELLOW COPV