P - 80555� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board oS ElecinciTy
1-380-336 � �821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTVlMR$ 1-800527�3529
www. electricity. s ta fe. mn. us
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I cetliiy that f am ihe f� LICENSED CONTRACTOP ❑ COMPANY ❑ OWNER and hereby requesi Inspectlon ol the elecirical work aC