P - 81373,. I I�III II I I I I( III I) I I II I III M8 n� Uota SsaO Bo LRm. SR1 PB,cSt PaPEMN ION04 �3�'���;
" 0 3 9 2 3 7 6 0't Phone (612) 642-OS00 '�"�• '"
Home Duplex Apt. Bldg. Other: New Addn
lv Gond. Htg Equip. Water Htr. n Load Mgmt. Other:
Jryer Range Elec Heat emp. Service
above the work covered by this request Enfer remarks in this space and on the back ot the white copy
SAVER'S SWITCH INSTALLATION
Calcula[e /nspectbn Fee - This Inspection Request will not be acceptetl without [he conec[ /ee:
Other Fee � Service Entrance Size Fee � Circuils%Feetlers Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Sheet Ltg./Traffic Sig. Above 200_Amps Above 100 Amps
Transformer/Generator INSPECTOR'S USE ONLV TOTA f
Slgn/Outline Lig. Xfmr. �4. 50
Alarm/Remote Control
1Oy � I horoCy certity ihat I Inspeotetl tne elecVical Inshallation descnbatl hereln on ihe dates stated
IrrigatCon Bo R�,9n-m oaie
X Speciallnspection 1 . 50 �
Final
Inves}igativeFee -�� Q�---�� �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
OFFICE OSE ONLY This request vold 18 mon�hs Imm vallda9on date Frintetl ir. tms Cox.
392-37�] � �s.�
/oZ6
JOH NUM$ER ll�N60m0
PLEASE PRINT OR TVPE
Re4�i� �� 30 ��8 Fouch-in i�spectlon required? Q Yes 0}I�o Inapetllon OMer Than RougM1-In: [}{ Feacy Now 0 Will Gall
no� m�ai �aii me ��spe�m, wn�� ,eeay) oA�e aeaay 11 / 30 / 98
I, � licensed coniractor ❑ owner hereby request Inspectlon of the above electrical work at:
Job Atldress �SVeet, Box or Route NoJ CiC Zip Cotle
05837 WASHINGTON ST NE F�?TDLEY JJi.jIL
Sectlon No. Township Neme or No. Range Na Fire No. Coun�y
ANOKA
Ocwpant Phone M1b.
ANDftEA LEIGH LILLEBERG 574-9702
Power Suppller Atldress
NSP MPLS OFFICE
BecVical Corrtraclor (Comparry Name) Conlraclor �censa No- Mester Lle. No. (Plant EIecL Only)
MASTER ELECTRIC CI�.,IHC. CA01192
ldailing Atltlrass�Gonhsctor orOwnerPerto.mirg Installa�ion)
it467 Bt70NE AVE �.SAVAGE MN. 55378
� nr � ��P� 1 941 f47i�/
EB-00001A-11 B/95 STATE BOARD COPY - SEE INSTRUCTIONS ORBACK OF YELLOW COPV