P - 80867REQUEST FOR ELECTRICAL INSPECTION �y��= �
� 1 � � — �+ �+ � � 1n821eUniversary Ave.,r Rm. 3e128,15t. Paul, MN 55104 ��. ��;
Phone (612) 642-0800 �
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Calculafe Inspecfion Fee - This Insps
Other Fee
Mobile Home Park Stall
Sheef Llg./Traffic Sig.
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Boom
b1gm1. Other:
Service
in this spoce and
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m Requesf will nof be �
8 Serv¢e Entrance I
0 to 200 Amps
Above 200_i
INSPECTOR'S USE ONIY
withou� fhe mrrect fee:
fee N Circuil!
0 l0 100 P
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Fee
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THIS INSTALLATION MAY BE ORDEREU DISCONNECTED IF NOT COMPLETED WITHIN 78 MONTHS.
OFFlGE USE ONIY TFis request void I B monYns from wGda�ion date prinfed in this box.
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PLEASE PRINT OR TYPE
uesfDaie kough�in inspedion requiredz Yes �''p.��
❑ No Inspecfion O�her Than RougMln: ❑ Ready No��+�� ill Call
�� 9 �Yo� musr mll the Inspxror when reody) Dme Ready: \
�licensed contmctor ❑ owner hereby request inspection of the a6ove eledriwl wwk ar.
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