994 Danbury Ct - Electrical PermitsThis request void (7/,-)
18 months from O/Of
E 4526P 1r2A2
9cV`2
I hereby request inspection of above
? OwnPr electrical work installed at:
St t 64d ress Box or o te No.
• CiIy??? \
ection o. Township Name or o. n No. County
Occu ant (PRINT)
o es Phone No.
Power ier Address
Electnca on?ractor {Company Name) C.tractyr's License No.
Maili s r o
f
Instailationl
Authoriz?
ja l?igna u r k
.?P? ,?A? ?PdL'lationl t
? v ? Phone Number
MINNESOTA STATE BOARD OF EIECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-791 BE ACCEPTED BY THE STATE BOARD
1821 Univarsitv Ave.. St. Pau1, MN 55104 UNLESS PROPEN INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
O&Igg REQUEST FOR ELECTRICAL INSPECTION . Es-ooooi -os
? See instructions for completing this fwm on back ot vellow copy.
E 45262 "X" Below Work Covered by This Request
M Fee ServiceEntranceSize M Fee Faeders/Subfeeders a Fee Circuits
0 to200Am s 0 to30Am s Oto 30Am s
Above 200 Amps 31 to 100 Ailips 31 to 100 Am
Swimming Pool Above 100^Am s Above 100_Amps
Transformers Irrigaticn Booms Pariial-er e
5igns Special Inspection g/ ' TOLjT'6J/
Rema ks r
.