3928 Beau D Rue Dr
k206 -443 ® OFFlCE SEyyNLY This request void 18 months from validation dab pnnted in this ~v
~o7;7/~ Ip.JJ
JOB #96010017
A
PLEASE PRINT OR TYPE
Request Date Rough-in mspernon regmredB ❑ Yes [1o Inspeahon Other Than Rough-In: Q Ready Now I'I It Call
(You muxf call the inspector when ready) Date Ready A 8$ I
1,0/07/96
, licensed Contractor ❑ owner hereby request inspection of the above electrical work at
Job Pdd W. (Sheet, Box, or Routs No ) city dp Code
3928 Beau D°
- non No Township Name ar No Range No Fire !A gan County
Dakota
Occupant Phone No
Cedarvale Business Center
Power Supplier Address
Eledn<al Contracror ompany ome) Contractor Lmme No. Master Lic No (Plant Elea. Only)
Hilite Electric, Inc. 040455
Wiling Address (Contmoor or Owner Performing Insmllahon)
.1953 Shawnee Road/Eagan, MN 55122
Aohorixed Signa nhacbr or Owner Performing In mllahan Phone No
G
1 452-8886
EB-00001A-10 6/95 STATE BOARD COPY-SEE INSTRUCTIONS ON BACKOF YELLOW COW
` (III II II I (III II III I II I III II II I I ICI BE~Ua University Board of ELECTRICAL
Paul, MN 85x104 Uj
IL 2 0 6 4 4 3w-4 *-Phone (612) 642-0800 b 8 g(~
Hnme Duplex Apt. Bldg. Other: Ht. Addn
Commercial Industrial Farm Remod Re air
Air'Cond. Htg. Equip. Water Htr. Load Mgrm Other:
r
~ D er Ran a Elec. Heat Tem Service
'R" above the work covered by this request. Enter remarks in this space and on the back of the white copy only
(RELOCATE SERVICE AND MOVE BRANCH CIRCUITS (tenant space split in two)
Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee:
Other Fee # Service Entrance Sae Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 0 t3q IjAmps 100.0
_QAmps 1 bove 1 0 Amps
Street Ltg./Traffic Sig. 1 Above 200_1D
Transformer/Generator INSPECTOR'S USE ONLY J. TOTAL
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pool I herb cemf thot .n d th ~ml ins on de Ac d herein on the dates stated
Irrigation Boom Roughdk Data
Special Inspection
Final Da e
Investigative Fee
THIS INSTALLATION MAYBE ORDERED DIS ONNECTED IF N PLETED WITHIN IS MO .