1949 Shawnee RdThis request void
18 nwnths from O
® IRK?1 . n ?A ?-7?7
7
Request Uate Fi No. Rough-in Ins Veclion
Requ uetl?
®Reatlv Now Q Will Nptify Inspec-
8/31/87 i Yes ?No for When Ready
Kj Licensed Electrical Contractor I hereby request inspection of above
owner electrical work installed aU
Street Address, Box or Route No. C'ty
1949 Shawnee Road Ea an
Section No. Township Name or No. Range o. County
Dakota
Occupant (PRINT) Phone No.
Knit Shoo
Power Supplier Address
N.S.P.
Electrical Contractor (Company Name) Contractor's License No.
Hilite Electric, Inc. 040445
Mailing Address (Contractor or Owner Making Instailalion)
1953 Sha ee Road
A riz d Sign9affing 1 tra r Own r Making Installation; Phone Number
,?Ti_m_Phi11ios_ -
THIS
MINNESOTA STATE BOARD OF ELE RICITY BE A INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-19 BE PTEO BY NNE STATE BOARD
1821 University Aye.. St. Paul. MN 55104 UNLESS ESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
f9871 , See instructions for completing this form on back of VallOw copy.
D "X" Below Work Covered by This Request
0 EB-00001-06
-7 7 7,';?7
Add Rep. Tvpe of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtules
Apt. Building Dryer Electric Heating
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Other pec, v .Ihnr ISner.lfyl
t .r Specify Other Other
Compute lnspection Fee Below
M Fee Service Entrance Sixe ft Fee Feaders/SUbfeeders k Fae circuits
0 to 200 Am s 0 to 30 Amps 2 36.00 0 to 30 Amps
Above 200 Amps. 31 to 100 Amps 31 to 1CIO Amp,
Swimming Pool Above 100-Amps Above I00_Amps
Transformers Irrigation Booms Partial"Other F
Signs Special Inspection $
emarka 36.50 Tor AL Al
?r
Rough-in Da?q
( c' I. the
T Inspector. hereby
testily that the above
Final Date v ' inspection has been
Q e/4 made.
this rammat void 16 months from