P - 83859REQUEST FOR ELECTRICAL INSPECTION ;:�
4`1. c! � 317 Minnesota State Board of Electricity
1821 University Ave., Rm. S-128, St. Paul, MN 55104
` Phone(612)642-0800
g Home Duplex Apt. Bidg. Other: New Addn
Commercial Industrial Farm X Remod Re air
g Air Cond. g Htg. Equip. Water Htr. Load Mgmt. Other: humlcl1f12Y
Dryer Range Elec. Heat Temp. Service
"X" above fhe work covered by this request. Enier remarks in this space and on the back of the white copy only.
Calculate Inspection Fee - This Inspection Requesi will nof be accepted wi►hout the correct fee:
Other Pee # Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLY TOTAL
Sign/Outline Ltg. Xfmr. 15.5�
Alarm/Remote Conhol
Swimming Pool
I hereb certi thaf I ins ected the elecfrical installation described herein on the dafes sfated
Irriqation Boom R�,,,,ha„ Da�e
Final r _ u re
Investigative Fee � � C,'/G-'- �J
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE USE ONLY This request void 1 8 months from validafion dafe prinled in fhis box.
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I I��I (I ��I II �II II I�I II �II � � II I�I �I I�I I IIII
* O 4 O 5 3 L 7 9* PLEASE PRINT OR TYPE �.5�
Requesi Date Rough-in inspection required? ❑ Yes � No Inspection Ofher Than Rough-In: �T] Ready Now ❑ Will Call
9/ 2 6/ 9 7 (You must call ihe inspector when ready) Date Ready:
I, � licensed contractor ❑ owner hereby request inspection of the above electrical work at:
lob Address �Skeef, Box, or Route No.� Ciy Zip Code
50�7 Bavarian Pass �/e,ST rriciley 55432
Section No. Township Name or No. Range No. Fire No. Couny
Anoka
Occupanf
Ryan, Noel
Power Supplier
NSP
Phone No.
571-8537
3115 Centre Point Dr Roseville 55113
Conhactor License No. Master Lic. No. (Plont Elect. Only)
Total Electric Inc CA02749
Mailing Address (Conhacior or Owner PerFoiming Insfallafion)
1537 92nd Ln NE Blaine MN 5
Authorized Si re IContracror or Owner Performinq Inst�llationl
786-8484