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P - 77256
REQUEST FOR ELECTRICAL INSPECTION 1— 5 6�— 8 3 7 � Minnesofa Board of Electriaty 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-800�27-3529 www.electriciry.state.mn.us I�II IIIII IIIII IIIII IIIII IIIII IIIII IIIII �� I� 1 5 6 5 8 3 7 0 Rough�nlnspec6on Required? LJ Yes You must call the inspecta when ready! p�,�D'� —C1�' � �Y✓ Irapedion Other TT�an Rough-In: �Ready Now Ll 1MII Call Dete Ready. . I ceAiy that I am the,�"IICENSED CONTRACTOR ❑ COlrff'ANY ❑ OWNER and hereby request �►spection of C�e elec6ical work at: