2105 Cliff Rd - Electrical Permits2 8 3? 113 ?
PLEASE PRINT OR TYPE OFFIGE USE NLY Thie rcquesl void IB manths fmm wlidanon dale pnnred m' b?O /
7f?/?'G !v e?
?
Requesl Uate
'
I
Rao9hin inspedian reqmred2 ? No
(You musl wll fie ins?r when reody)
Inspedmn Oiher Than Roogh-ln 0 Revdy Naw Will Coll
Dote Ready
I, 04censed mnfrocfor ? owner here6y requesf mspedwn of ihe above elednml work at.
Jab Pddress (Sh , or RoWe No.) Ci Zip Cade
x?
$ecM1On No Township Name or No Range N. firc No_ Co
Occapont
2 Phone N.
PowerS
lier Addrees
ElMnml Conhacror (Company Nome) Conlraaor M4cenze Na Maaier Lc Na (Plani Eled. Only)
W
Mailing Address ?Conhacro? or Owner Pedorming Insmllmion)
' t?- _zS/ 1
Auth gnaNmiC nkacror rOwnerPedormin Insfallanani PhoneNo
E13-010001A-1006/95 STATEBOApDCDVY-SEEINS7RUCTIONSONBACKOFYELLOWCOGY
i) 11111111111111111111111111111111111 IiI 11111 REQUEST FOR ELECTRICAL INSPECTION
Mmnesota State Board of Electnaty
1821 nroersity Ave Rm S 1 8 S Paul MN 55104 4 004
* 0 2 B 31 li 3 9 * phone (812) 642-0800 '??,3 S(o
Home Duplex Apf Bldg. Other: New Addn
Commernal Industrial Parm Remod Re air
Ad Cond. Hfg. Equip. Water Hfr. Load Mgm}. Other:
D er Range Elec Heof Tem . Service
"X" above ihe work covered by Ihis request. Enler remarks in fhis spoce and on fhe back of the whde copy only.
K?4F uzrocl
Colculafe Inspechon Fee - This Inspecfion Request will not be accepted wdhout Ihe mrte<t fee-
ONher Fee ;F $ervice Enhnnce Sae Fee # Circuih/Feeders Fee
Mo6ile Hame Pork $tall O to 200 Amps 0 fo 100 Amps
S}reef Lig./Traftic $ig. Above 200 Amps A6ove 100 Amps
Transformer/Generafor INSPECTOfl'SUSEONLY TOTAL
Sign/Oufline Ltg. Xfmr ? JV
Alarm/Remo}e Conlrol <r`/
$wimming Poal I hereb cem fhot I ms nmm mlollanon desmbed hereun on fhe dahs s d
Irrigafion Boom Ro.qh-In K
$peaal Inspedion r
Invesfigotrve
Fee Finol
,Xl
THIS INSTALLATION MAY BE OROERED CO ECTED IF NOT COMPLETED WITHIN iB M NTHS.
OFFlGE USE ONLY This request void 16 monlhs hwn volidation tlak pimeu m mispO
/-) -4.? • /?-
?/??
in?•??
?i1L
IIIIIIIIIIIIIIIIIIIIIIIII
III?IIIIIII ?
I
8L 4? ?
' j?0
pLEASE PRINT OR TVPE
Ik a 4 4 7 8
Reqoes? Dot RouaMm mspenion ?eqmredR ? No Inapecnon O?hcr Than RougMn ? Beody Now dl Call
i G. G
6 ?Yov must call the inep ior when readyl Date Reody
I, V,Jicensed coNmctor ? owner hereby request inspection oF the above elechicol work at
la6 Address (Sreet, Box, or Rouie No )
. Ciry Lp Cada
C>5
Senion No Township Name or No Range N. fhe N.
Ca?
?
Occopont Phma No
?
Pawer Supplier Address
Eleclr¢ Conhocror (Compo" Name? Conhocror Lcenu No Mamr Lc No. IPlam Elecl. Only)
?v?uL? , c cc? ? 4a
Modmg Address (Convactm ar O er Performtrg Insmllanan?
?
Aulhoriz ignamra (Conrcncr ern9lnsbl %rone No.
E6U0001A-1 I e/96 ~ gTpM BORRD fAPY - SEE INSTRUCTIONS ON BAGK OF VELLOW COPY
y/?S/97 REQUEST FOR ELECTRICAL INSPECTION ?°?? ?•
4 4 7- 8 81 ? 1A821QUni?versity ABe,rRm. 8-?128,'St. Paul, MN 55104
Phone (612) 642-0800
H
me Du lez Apl
Bldg. 06er: . New Addn
'Net o
Commercial Indushial .
Farm Remod Re air
Air Cond Htg. E uip. Water Hh. Laad Mgmt. Other:
Dryer Range Elec. Heot Temp. Service
"X" above the work covered by this request Enfer remarks in thn space and on the back oF Ihe white copy only.
Remma- o,= s*'%A--) a0cirn
Colculate Inspection Fee - This Inspec/ion Request will nof be accepted withouf fhe torrecf Fee:
Other Pee # Service Entrance Size Fee # CircuiLS/Feeders F?
Mobile Home Park Stall 0 ro 200 Amps 0 to 100 Amps
Street Ltg /7m'rfic Sig. Above 200-Am s ove Amps
Tmnsformer/Genemtor
?Cn
INSPECTOR'S USE ONLV
C??
TOT L ?
Xf
li
L
S
O
mr.
ut
ne
lg.
ign/
Alarm/Remofe Control
Swimming Pool I hereb cem ihai I in ted et J cd6ed herein on the dale:: d
Irrigafion 8oom RougMn DO? a7
$peciallnspecfion F
l
Investigative Fee
?u'c IucTnI 1 eTlnu M
eY RF O ??e
RI]ERED DISCON RHIN 1 N HS.
This Fepvest void
18 rtqnihs Irom
Reques1 Date
. `
Fre No.
Ro ' h-,n InsVecUan
A '
retl?
?Ready Now WilI NoUfv InsOec-
? ?es ?NO or When ReatlY
Lirensed Elecvtcal Convar.tor I heraby request ins0ecp nbove
Owner electncal work mstelJed a??[ ?
Street Atldress. Bon or Route No. C'lv _
A 0?
ecimn o. Townshio Name or No. ange No. \ ?\u ?
Occuu IPHI
, ?; NT ?
l 7a Phone No. ?
Pnw $upDl er /?ddress ?i+ ? b?
Gncal ConVactor ICOmpa y amel Cnnnar.lor's Licenae No.
I
n AAJress IC vactor Ow r M ki P. Insta. atio I
Q
Auth i tl Sign ure o hactor/Owner a iny Inst Ilabonl Phone Number?7?/
MINNES6TA STATE BOAPD OF ELECTHICITV
Griggs-Midwey Bldy. - Noom N•191
1821 Univereitv Ave.. 5t Paul. MN 55104
Phone 16121 642-0800
BE 'ACGEPTED BY TME SiATE•BOARD
UNLE55 PROPEN INSPECTIOM fEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
? See inshuctions tor campleling this lorm on Oack of Vellow co0v.
ti ea-ooooi-os
?p 2
?/??J ?
?r Q_'?,rj 7-'? "X'" 8elow Work Covered by 1his Request
Add Beo. rvae of awlamg p.aolancas wvee Eqoiu?+enl wveA
Home, Fanqe Temporary Service
Duplex Water Heater L??htmg Fixtures
Apt BwlAing Dryei Eler.irve Heatin
Commeraal Bldg. Fumace Silo Unloade?
Industnal Bldg. Air Condiunner Bulk Milk Tank
Farm me? So?•?.? v oinF? lsuc?.?fvl
tMr uecAV Ncr Otnvr
?.w
p upai o
Fee Nc
ServiceEntrenceSize
B
Fae
Faxders/Subfeaders
a
Fen
Circuits
0 to 200 Am 5 0 to 30 Am >s 0 tn 30 Flm ns
Above 200 qinps 31 to 100 Amps 31 to 1U0 Am s
Swimmin,y Pool Above 100-Am s Above 100_Am s
Transtormers Irrigation Booms Partia6 Other ee
aigns $? OV TOT
Rema rks
?..%.
inal
me
^1l.?'+ inspacmr, nereby
? ,fy that the above
E? nspechon has been
-12 mede.
This request void
18 ?1qnlhS Irom ?
?t7
E 31817 ??
Hepuest Uale Fire No. ,pey?uhretl???"Ue.ctwn rSS L3qeaAY Nuw Q Will NoLly Inspec-
10/25 88
LMYPS
?No tur When Headv
g] Licensed Eleccn,.al Contmctor I herebv requast insvacLOn ot ebove
Sveet-AAdress, Box or Route No.
210$S C1iff Rd E
¢c?ion o. Townshi0 Name or No. RanOe No. County
Dakota
Occupanl(PRINT) Phone No.
PROEX
Power SupOLer Adtlress
Cnnoror,tor'e Gcense No.
Electncal ConVactnr (Company Namel
Hiiite Electric, Inc 40445
MailinB .4dJress ICOnVaclnr or Owner Makmp Instailatonl
1953 Shawnee Rd Ea an, MN 55122
Ayt ed SignaW o ra?wr/Owne' Making Installatinn) '"
452- 3886
.. ,,c ? icocrrinu ncnucsT wILL NoT
MINNESOTA STATE 80APD OF ELECTNIGTV
Gnygs-Mndwey Bldg. - floom N•191
1821 Universilv Ave.. St. Peul. MN 55104
Phone I6121 642-0800
BE ACCEPTED BV THE STATE BOARD
IINLESS PROPER INSPECTION FEE IS
ENCLOSED.
1?/,7/?-le REQUEST FOR ELECTRICAL INSPECTION EB-00001-06
y'
? Sae insvuct?ons ior completo?9 tMis form on back of vallow coOV.
? 3 1 8 17 "X" Beh9w Wor;r Covered by Ihts Requesf
-T- no i w_ a ea-Pena?i W?.ra
en,? Nwo. Tvoe uf ien,u 1
Apt Bwiding Dryei Electn
Commermal Bldg. Fumace Siln Ui
ust nal BIdG
Ind Au Condiboner Buik M
_0,E,? 1
Farm omrl . P „cl v _
t A1 SVCf,I y
pther
Plhur
rte InspecLOn
Fee Service xders?5ubfeeders d Fee
C
1 30
0 ro 20 30 Am s .
Above
M to 100 Amps
=
Swinvn E ove 100-Amps
gat?on Booms
Transi
S??s cial Inspecbon
5
30.5?
Final
TlusreQuest
TOTAL E? 6 O'
I, the Electncnl
InSpeCtor, he,aby
'cerldy that the above
inspecliort has been
mede.
Th,s re9ue5t wld IAI
18 manths from ? /' ?t? ?D • '` T
A +?R2.62o p ?..
Renuest Date F1fe pequ red7 ?sOeM? ? ?Ready Now Nobfy InsPec-
? ` (? ` (/ ? YB5 ? lor Wt{en R¢atly
?/
p ucansetl Elec[ncal ConVactor I hereby raquest ins0ection of abo,`e
-.......vi ......i, mztwl Ind eL ...
Streei AAtlrQss, Box or Poute No. ??? ?
cGC%sX?L. 4 , t -c ? r C?
ecbon o. Township Nnme or No. Fan9e Na• C° ?ty
K4
i•r-
Ocr.uo,ini (/PRINT)
GCd A-R- n/
?Ti 1,/ Phone No.
Pa r Sup lierl
?Ta dss
' Electnca? Cnntra tor ICOmpany Namel Conhar,tor s Lice=se No.
2 la ,lic. ' ?fu ?/ ?/
Mailvig Address ICO vactor or Owner Makinu ??y?$iIatLoN
? ?/?
Au ¢ gnat IC tractor Ow r Making InstallatioN Phone Number
CCT WII I Nl1T
MINN(ESOTA STATE BOARD OF ELECTflICITY
Gr,g9s-li Blda. - poom N•1e1
1821 Univers?ty Ave.. St. Paul, MN 65104
Pbone 16121 297-2111
BE ACCEPTED BY TME STATE BOARD
UNlESS PNOPEN INSVECTION FEE IS
ENCLOSED.
? 1 I?-?.LV REQUEST F( "':AL INSPECTION ?°?mtu EB-000n01-09
' See instructior., ,,,. ..,,,wletina <his torm on beck of Vellow copy. ???? ?X?
V
An R, ?j j "'X" Below Work Covered by This Requesi
AAtl ReO? Type oi 8uilding APplinnces WiraO Equipment Wired
Home Range Temporary $ervice
Duplex Wa[er Heater Lightin, Fixtures
Api. Bwlding Dryer Electnc HeaLn
Commercial Bldg. Furnace Silo Unloader
Industnal BIAg. Air CorMrtioner BWk Milk Tenk
Farm che, ven v Tt ne. lsnecifyl
t r Sueci y Other Other
ompu2e Inspection Fee Below
N? Fee ServmeEnlreneeSize p Pea Feadere/5ubfeeders M Pee Cucurts
p?p-p U to 200 Am s 0 to 30 Am s -O,rO 0 tn 30 Am
A6ove 200 qmps 31 to 700 Amps 31 to 100 qm s
Swimmin Pool Above 100_Am s Above 100_Am 5
Transformers Irngation Booms Partial-'Other Fee
Signs Special Inspection S
SZ7
1
TOT FEE
FlertnfkS ;
0 ?
l.n.n/"
?/?^t +'/ _L W -
Nough-in Date I, the Electncel
IaspBC?oq herBby
cerL/y thet the xbove
FIOdI Dale IO9peClIOO hd3 b880
• . 9 ?/k nanda.
Thie renuesl void 18 monlhe from
Thr} reauesl voitl???/??
18 ???hs lrom ? Y ) ? ?
? O
2 5 9 -10
Request pate Fire No. ph-in InsVecuon
retl? ?fleady Now?Will Noiity InsPec?-
- Yes No lur When Readdv
/ \Licensetl Electncal Convactor ILhereh requast
/ Y iAlpection oi abov?
? OWnP.r elaCtrlcal wnrk .4afwllwd
Street Adtlress. Box or flovle No. , Cny?
-
L? Z
xcuon o. Towns,ap Name or No. Ran
ge o. Coun)ly /
Occauan (-PRINTI .
, _
a - (,
Phone Nn.
/
cJ ?/ ? ? T_J??l
Power Soooiie.
A tlress
s
CI,e C%v2 ? (
Ele,tncal Convacmr (Company Name) r
I)
?? Cnnvertor"5 License No.
Ida?lin Address (Co vacio ov'Own r Makinp Insmilauonl/
Au?h r etl ipn e onuactor?Owner aki p Installation) Phone Numbe.r
`-? i-
mmncsUIA STATE BOAflD OF ELECTflICITY
G?'gea-Midway Bltlg. - qaom N-191
1827 Universitv Ave.. SL Peul. MN 55104
Phone (612) 642-0800
inib irvSYECiION REQUEST WILI NOT
BE ACCEPTED BY THE STATE BOAND
UNLESS PROPER INSPECTION FEE IS
ENCLOSED,
A/?2118;5' REQUEST FOR ELECiRICAL WSPECTION es.oooai-o?
C n ? See instruc[ions (or complebnB this form on beck of yellow copY. g0y 9(/
E L J J'i 0 "1(` Below Work Covered by This Reques7 gY,311
Hdtl Pep Type ol Bm1EmB Apphancen WrteO Eqmument Wved
L I I I Ouplex I I Water Heater IX I Liahtnna F?x+...vo -?
? 1 ?-?????„c??„?i oiuy. ? rumdr,e Jib UnIOeJ2r
??L j Industnal Bldy. S Air Conditinner Bulk Milk T?.,k
Farm
p Fee Serv?ceEntrenceSize tt Fee Fexdees/Subieeders N Fee G'cuits
- U to 200 Am s ><u' ? to 30 qm s 'i 0 tn 30 Am s
?or: Above 200 Amps] .? J 'k=nw 31 to 100 Amps cv 37 to 100 qm s
Swmmiing Pool LORPig Above 100_Amps A6ove 100_Ampe
Transrormers ?o?? IrrigalionBooms Partial. e
r?
zj?w-)w
Requesi Date
1 Fire No Fough+n I
Requiretl ' eclmn
?
?Reatly Now ? Will No[iN Inapeclor
} ? Vw ?,NO Wlien Ready?
IA licensed contractor ? owner here6y request inspeclion of above electrical work at:
.bb AdAress (Street, Box w Foute No.) CitY
?IOS C LTFF - " G-f1-
Secnon No. Township Neme or No. i Range No. Counny T
L/ ?? I ft
OcwparN (PRINT)
'
- Phona N.
-3y? ?
C
C) cF-Pl
Power Supplier Atldress
ElecMncel ConVactor (COmpany Name) CoMractor§ Lnense No
s-176Ai r o. x,v e a.5 (0 a
Maling Address (COnl2ctor or Ownar Meking Insiellation) S UFT E
S ,r 551,J o
nz na / akmg Installation) ne Numb
er
Pho
v
}? /?
/
MINNE TA STATE BOARD OF ELECTRICITY TMIS INSPECTION REpUE$T WILL NOT
GriB9a- tlwey eltlg. - RDOm S173 BE ACCEPTED BY THE STATE BOARD
1621 Unlvereiry Ava., M. Peui, MN 55101 UNLESS PROPEF INSPECTION FEE IS
PhonB(612) fi42-0800 ENCLOSED
REOUEST FOR ELECTRICAL INSPECTION M ea-ooooi-07 ,
ji? See instruclions lor compleLng ihis form on back ot yellow wpy
c?
Ft- 7'1 RFl q 'X" Below Work Covered by This Request
e Adtl Rep. v TypeofBuiltlmg AppliancesWired EquipmeniWired
Home Range ary Service
Duplex Nlater Heater Heating
EI?trlc
Apt. Bui lding Dryer L
Specify)
Comm.llndustriai Fumace
Farm Air Conditioner
Dther (specrty) Contrador§ Remarke: ?J Z
5?.7:LC-t
20A.
Compute Inspecbon Fee Be/ow:
# Other Fee # ServiceEntranceSize Fee # CircmtslFeeders Fee
Swimming Pool 0 to 200 Amps 0 to 700 Amps O.(?
Transformers Above 200 _ AmpS Above 100 _ Amps
Signs Inspecmr5 use Onty: TOTAL
Irrigation Booms 6 •
Special Inspection
AlarmlCommunication ?
Other Fee
I, the Electrical Inspector, here6y RO1gh-i" oe'e
certify that the above inspection has
been made. Finel oile
? ?U ?
OFFlCE USE ONLY _
Tlns raque9t votd 19 mOnihs irom
L
5 40
9 ?
,L/ / Cl ? .dgw
R¢QUest ?ale Fire No n-in Inspenion
eqmretl?
? Ready Now ?Will Notity Inspector
j I ?
J Ves C No When Feady9
licensed convactor D owner hereby request inspection of above electrical work at:
Job <.oarew (Street 6ox or Route No I
l05- 42aa- d Qry
Ea ?
SecMion No Township Name or No Range No Counry
Ocapant P INTI ,n
0
' Phone No
d
G+e-?
POwer SUpOb¢r Mtll855
Elecm al Convactor(GOmpany Name)
G Connacror5 Ucense No
40 O?5
C
ev, ew c. ?
MaOng Atldress (GOmraaor or pwner Making Installabon)
1 . : iisb?? ? se? V7r
AWhonzetl Si n r CoMrac1onOwn?er /M?abn ?IJnstall onl
"ptG Phone Number -??
MI ESOTA STATE BOAFD Of ELECT CITV THIS WSPECTION REQUEST WILL NOT
Grlggs-MMwey BIOg. - Raom 5-173 BE ACCEPTED BY THE STATE BOARD
1811 Umversity Ave., 51 Peul. MN 55106 UNLESS PROPER INSPECTION FEE IS
phane(b1p?gy2.peepp ENCLOSED
T EB-00001.08
?//? /y/y/y???'''yq REQUEST FOR ELECTRICAL INSPECTION ?. `a8?5
9/ e O? See msimcuons lor compleling this torm on back ot yellow copy
?y/ /,(
I 1 L?? 4 °x^ Ralnw Work Ccvered by This Request '???•
w
ew
Atld
Rep.
TypeofBUilding
AppliancesWired
EqwpmeniWUed
Home Range Temporery Service
Duplex Water Heater ElecVic Heating
Apt Bwldmg Dryer OtheF-(Speciry)
Comm./Industrial Furnace
Parm Au Conditioner
Otherlsyecdy) Contraclor's Remarks
Compute lnspechon Fee Below:
# Other Fee # Serwce Entrance Srze Fee # Circmis/Feedars Fee
Swimming Pool ? 0 to 200 Amps g 0 to 100 Amps
Transtormer5 Above 200 _ P.m Above 0_ Amps
Signs Inspector5 Use Only
/ TOTAL /
?
B ? ??J 10(O
ooms
Irrigation
Special Inspection
niarm/Communication TNIS INSTALL ORDERED DIS ONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO r -
I, the Elechical Inspector, hereby Rou9h.in
t:,.Ae
certify that the a6ove inspection has F,n,i oate
r ( ? 7
been made.
OFFICE USE ONLV
TNS request vot0 18 montns imm
L_
Thiv reque+t vonj
??/?/J/y? _
18 months irom
DD 92167 0 / igi/? f, ,(ir""O?_',,,/1??, ..DDi, il
,M ? -
12 '
° V
Reque?t Ua?e qre No. F h-in InsVeciion
RP4unedI
E]Reatly NowNrWill No1rty Insoec
Wh
t
? ?? ?J S ?yes EJNO or
en Ready
? L-censetl Electrical Cnnvactor I hereby reVuest inspection of ebove
? Ownei electneal work msiallad at
Sbeec AAAress, Bov or Route No. Ciiy
G/
' F
/
?
1 jA
ectmn o. Tuwns??p Name or No. Range No. County
3e /r0
OccvpantlP7 Phone No.
e'EI Ia j
r,
Pciwer $upplier Atldress
Electncal Contraclnr ICOmpanv Namel Convar.mr?s License Nn.
Mailinq AtlJress 1 onvactor or Owner MakinpIns
tallaLOnl
_
7c ?JC cf ? c/i i.2
AolhorveA Signafurc ICOMractod-0wne, M'np Installavonl Phpne Nu iber
?'
a /
MINNESOTA STATE BOAPU OF ELECTflICITY
Grig9s-Midwey Bldg. - qoom N-191
1821 Umvercitv Ave . St. Paul. MN 65104
Phone I6121 642-0800
THIS INSPECTION PEQUEST WIIL NOT
9E ACCEPTEO BY THE STATE BOAflD
UNLESS PpOPEP INSPECTION FEE IS
ENCLOSED.
REpUEST FOR ELECTRIt,AL INSPECTION ea-aoooi-os
' See instruciians lor romplet "B th:s form on back of veliow wCV.
D 92670 "X" Below Work Covered by This Request
lil? AAtl Rep. Type oi BaJding ADPliontea WiroO Eqmymemt WveJ
Home Range Temporary Scrvice
DupiHx Water Heater Liyhtiny Fixtures
Apt Bwlding Dryer Electnc Heabn
Commercial Bldy. Pumace Silo Unluader
Indusinal Bldg. Av CondiLOner Bulk Milk Tank
Farm oinrr oI'iry otne, Isn.u.. tvl
?,?? sue??rv ome, 01m,
(:ompute /nsDecbon hee Helow '
p Fee SarvicaEnbence5ize b Fea FexJers/Subfeeders k Fee Grcuits
0 tp 200 qm os 0 to 30 Am s 0 tn 3
Q An+ S
Abuve 200 31 to 100 qmps 1 to 100 Am s
Swimming Pool !>bove 100Amps Above 100Amps
Transtormers Irriyation oms g Partial.Other Fee
$igns S?leCidl IitS?JeCtiOil T
Pemxrks r' ?. OTA EEn.
r.,
ie//" / /' /?? -
iouBh-in r Cl,i
+ I, the Elecincel
InsDector, haF aby
cerldy thnt Ihe above
Fnal e??G
I - esoaeroo hes been
r rtieCe.
fhn repuest void 18 monihs imm
? ?y ? a?aa y
C? 0 2 4I/ U"°
41.0
FeQUes:Oate
L Fne No tirough-In InpseMwn Reqmrge
mrywhen reaEy)
(vou must call inspec Inspecimn 00er Than Fough-ln
? qeatly Now ? Will Nolrly Inspector
I~ ?
? Yes ICJ N. Oale Reatly
I 91 :icensed contractor ? owner hereby request inspection of a6ove electncal work at:
J?
Job Atltlress ISVeeI Box or Rame No i CM
ZA
Seciion No Township Name or No Range No unry
OccupantlPRINTI ^? ??•
lJ? Phone No
Power Supplier Atltlress
Eiecmcai Con,ractor fCompany Namel '
'Menn0+c, rClec_-WlOYY??. Convector5 Licsnse No
C. Fl C) -ZC? Z
Meihng Aoeress fCOnlraclor or owner Meking InslalialioMnl
Hutholii ndture 1 nbBC?onO nsta111du0n? Phone Number/^^ ?
MI SO E RD OF EIECTHI THIS INSPECTIDN REOUEST WILL NOT
gge"Mitlwey - Room 5-1]] 8E ACGEPTED BY THE STATE BDAFO
Btt Uniwrs ve.. 5t Peul. MN 5 < ?"ro r UNLESS PROPER INSPECTION FEE IS
Plrone (61 642-0600 ? ENCLOSED
oqp00 Qy8.
REOUEST FOR ELECTRICAL INSPECTION ?F07"-"my9e
0.S
7t?? eeinstrucbons lo: wmpleling this foFm on Oack oi yellow ropy ??p(? J
M 0 L 74 "X" 8elow Work Covered by This Request
ew Adtl Hep. TypeofBmidmg AppliancesWired EqmpmeniWiretl
Home
Duplea Range
Water Heater Temporary ServiCe
Electric Heating
Apt Bmlding oryer Load Management
Comm.llndustnal Fumace Other (Specl(y)
Farm Air Condihoner
Otharkspemfy) ConVaolors FemaMa
Compute Inspechon Fee Below:
# Other Fee # Service Entrance S¢e Fee # Cvcuits/Feeders Fee
Swimming Pooi 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 1001_- Amps
SigpS Inspectar's Use Onl?r TOTAL
Irngation Booms
Special Inspecnon
Alarm/Communicauon THIS INSTALLATION MAY BE ORDE DI ONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspector, hereby Rough-in oete
ceridy ihat ihe above inspection has
been made p,,,ai
? oere ?_c(
OFFICE USE ONIY ?
This requesl voitl 10 months Irom