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P - 77023REQUEST FOR ELECTRIC� INSPECTION 1� 6� 5- 9 3 0� Minnesota Board of Electricity ��� �j `(1�1��'(� 1821 University Avenue Suite S-128, Sai aul, Minnesota i'6 (651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us (��� ����� ����� ���i� ����� ���������� ������� �� ��Co� p�m�,� 16859308 �te: Rough-in Inspeclion Required? ❑ Yes No Ins ^ pedion Other Than Rough-In: ❑Ready Now Will Call e� �, D� Yau must call the inspeUa when ready! Date Ready: I certiiy that I am the f�'LICENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request inspection of tlie electrical work at: