P - 75626r� REQUEST FOR ELECTRICAL INSPECTION
G�� ��° 0 7 1 � Minnesota Board of Electricity
1821 Universfty Avenue Sufte'S-128, 5ai�it Paui, Minnesota 55104
.(f�.�642-Q800T1Y/MRS 1-800-627-3529 www.edectricity.state.mn.us
Desaibe -using the back of the whlte copy'rf necessary - the work covered by this requ�st:
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SERVICES / POWER SUPPLIES
AIARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
3 to 12 Un(ts C�D $50 Per Unit
Manufadure�i Home Park Lots I
R�reational Vehicle Park S'des
THIS INSTALU4TION MAY BE ORDERED
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2122�71�
Rough-in Inspection Required?
You must call fhe Inspector when
ONE & Nd0 FAMILY DWEWNGS, EACH UNIT
Includes the Servic� and/or Power Supply up to 500 Amper�, All
C'ucuits and Two Inspeclion Trips Each Dwelling Unit @$80
(minimum total fee is $20) � �,'� � 5(
TFIISAF�AFORINSPECTORUSEOALLY •
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I hereby certKy fhat,I inspected the e�Ctriml installatlon descnbed herein on fhe dates sfeted:
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JUN 14 2007
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❑ No InspecUon Other Than Rough-In: ❑ Ready Now � Wi0 Cell
Dffie Ready.
I certify that I am the �LIC�ISED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at