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1262 Deerridge Ct - Electrical PermitsThis re4uest void 18 month5 trom C 16804 ;Request Pat { RQUhed?inSpei n ?peady NoWill NotifyInspec? Q ?? es ? No tor When Ready ensed Electrical Contractor I hereby request inspection of ebove a? -.,.L ;nntatled at: LJ Vwner y C i Street Address, Box or Ro te No. _ d ? J i ecUon o. Township Name or No. ange No. COyL?Y / 1NT t iPR OccuGan Phone Nn. ? `? Power SuPPI r Address c N e) Cont actor"s License No Electriq?/?Qntrac (C vr1 - m v ?f? C ?? ?., r Mailing Addre?s (Ci?ntra r or Owner aking In lail tion) Authorize ignature o ntractor e ak' stallationl Phone Number T ? ?racocrrinfu acAUFST Wlll NOT MINNESOTA STATE BOD OF ELECTRICITY J? BE ACCEPTED BY THE STATE BOARD Griggs•Midway Bldg. oom N-791 / f UNLESS PROPER INSPECTION FEE IS 7821 University Ave., t. Paul. MN 55104 U ENCLOSED. Phone (812) 297-2111 -OU001-O4 / i REOUEST FOR ELECTRICAL INSPECTION See instruclians for comoletiny this form on beck of yallow copY. E8 - . ._ . -:_ o_...-s 7 ? ?