2900 Lone Oak Pkwy - Electrical Permits
2`11-134 OFFl EUS ONLY Thrs request void IB monihs fiam volidanon date pnnred tn Mis box
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SE PRINT OR TYPE
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Reqaesl Dak
q"($-QS Roogh-?n mspMion requved2 ? Y ?No
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t Inspecnon Olhm Than Rough-In? Reody Now ? Will Call
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I, ? licensed confrador Q ownar here6y request inspedion of ifie above eledri cal work o}'
Job Address (Stmeq Bo; or Rouro No )
AqOm La,ne Gbkl 61-612 Ciry
Ea r? Zip Code
.55/a/
Sxnon N. Township Name ar N. Ronge No. Fire No Co?ny /?
/? L
Orcvpvm
g/eAftntz ?&?a S siPm-S Phone N.
g58-5937
Power Supplmr Pddmss
ElpcMml Conhatlor (Company Name)
f'!
l S CoMndar h¢nse No
g Mvenr 6c No. (Plvn, Elad. Only)
o
ecuri a
Moiling Addmss ( ankacror or Owner Perfortning Insbllahon?
903" ?ror?d
Auihonzed SignaNre (Cantmcroror Owner Pedorming Insmllanon) Phone No.
EB-OOOOlA-10 6/95 STATEBORSiDCOPY-a INSTRUCTIONSONBACKOFYFILOWCOPY
A
IIIIIIIII
* 0 2 0 7 13
4 II IIII REQUEST FOR ELECTRICAL INSPECTION /?-`f ". `
Minnesota State Board of Electricity
1821 University Ave., Rm. S-128 St. Paul, MN 55104
8* Photie t612i-842-0800 O/Co QS ?""
Home Duplex Apt. Bldg. Olher: New Addn
Commeraal Indushial Farm Remod Re air
Air Cond. Htg. Equip. Water Hir. Load Mgmt. Other:
D' er Ran e Elec Heat Tem . Service NOM1T'oR 5//IVK6 DETEBY'DRS
above the work covered by this request. Enter remarks in fhis spoce and on ihe back of the white copy only.
SmoKe defeeors (appro,r;.xofP/y /a ) are kei.ry 1.4slo/I'ed
?y e%c?r,•ca/ oonfroc?or. 1?lrrn9 6y e%rfi,'c.at. N-Ajd ?anron;'ler.
Calculate Inspedion Fee - ihis Inspechon Request wdl not 6e accep/ed wifhout fhe mrrect fee:
Other Fee 3i Service Entrance S'ae Fee # Ciraiits/Feeders Fee
Mobile Home Park Stall 0 fo 200 Amps 0 ta 100 Amps
5}reet Lig./Fraffic Sig. Above 200 Amps Above 100 Amps 4552
Transformer/Generator INSPECTOp'SUSEONLY TOTAL
Sign/Outline Ltg. X(mr.
? Q d,...?
-I/7:7'v
Alarm/Remote Control 1 ,Qp
Swimming Pool
I herob mm that I im Med the eledncal insmllahan descri6ed herein on the dotes swed
Irrig6}ion Boom Rough-ln Wk
Speciallnspechon
Investigafive Fee Flnol ? /f ^
D'
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 1B MONTHS.
j ] REQUEST FOR ELECTRICAL INSPECTION
II??IIIIIIII II II II?II II I?I IIIII I? II III Minnesota State Board of Eleciricity
1821 University Ave., R?S?t?$Q? Paul, MN 55104
QiN
* U? 4 3 3 2# Phone (812) 642-0800 ?
Home ? Apt. Bldg. 11 Other. New Addn
Commercial Indushial Farm Remod Re air
Air Cond. Htg. Equip Water Hta Load Mgmi. Other.
D er Ran e Elec. Heaf Tem . Service
"X" above the work covered by lhis request. Enter remarks in Ihis spoce and on the back of fhe white copy only.
Calculate Inspechon Fee - 7his Inspechon Request will not be oaepted without ihe corcxf fee:
Olher Fee # $ervice Enkance $ae Fee # Circvik/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps j 0 t0 100 Amps 0
Sheet Ltg./Traffic Sig. Above 200 Amps 222??Amps
TfanS{olmel/Cienefafot s INSPECTOR'SVSEONLY T TAL
Sign/Outline Lig. Xfmr. c? 3, G Z 3
Alarm/Remote Cantrol
Swimming Pool
I hereb cemi ?ha? I im detlncol' II ion esr116ed herein on Ihe daha shrod
Irngation Boom Ro?gh-In /? /
' /' Date ?.?
Special Inspeciion n v t
vC
Investigafive fee Fuwl pa
THIS INSTAIIATION MAY BE ORDERED DISCONNECTED IP NOT COMPLETED WITHIP&D THS.
2 L"! - 3 3 9?l
1 OFF CE U E ONLY This reqvesl vmd 18 monMs from validanon date pnnhd m fhis ?
?? s
PLEASE PRINT OR TYPE
Request Dare Rough.in mspechon requiredY Pr ? N. Inspedion OtherThon Raugh-In. 0 Rmdy Now ET'14111 Coll
?/ Z (1'0o most mll the inspeclar when reody) Doro Ready-
I, Lcensed <onfrador Q owner hereby requesf mspedion of fhe above eledntal work aY
Job P
d
drms (SVeef, Box, or Route No ) Gy Zip Code
(
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2. l k ' `a Z
Senian No Townahip Nome or No Range o Fire N. Counry
" DA
Orwpanf Phone No
PoGerSuppLer Pddress
Elennml Canhocror (Campony Name) Controtlar Liarue No, Masbr Lic No (Plont Eled Only)
\G L'Ab -7'O
Moiling Pddress (Conhoqor or Owner Peho ing Insloliafion)
l03 -
ANhorizad5igrw fCon crorar nxPeAo?min anon) PhoneNo.
`
40 `\44 -14no
EB-OOODIA-IO 6/95 STA BOARDCOPY•SEEINSTRUCTIONSONBIICKOFYELLOWCOPY
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Ra0usil ab"' - . FrtaNa. Ro Inipecti0n . • '
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..,., 10dy NOW ? Wpl Nolily Inspeclor
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?Ju:arrsed contractor 0 owner hereby request Inspection of above ` lectrical workat: ,.>- ---.• ..
'°-•. _,
4t
'
($1fBBl BOX WU7J0.? r
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-
apion No. wnehip Nem0.s! No. Rarpe No
OccuPantIPRINTI
Akg,
Phona No., . '
PawerSupDlyr . W
Ebctnca mrac Com • .. ' Cqnlreomq Ucqnse No. ' .
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bn9 A tlr ss ConV ID D n sbnp Insiplletron) ,. . - •- .. ,
St? 7
ftuthonzatl Sip rp IC ctayOwMCMekinq Installelionl Phone NumpBr;'
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9TA*90AND OF ELECTAIFITY - w nM TH?gJy$p.SCTION NEOU8S71?51LL NOT?
ey Bbg. - Foom bti7 r/- BE ACCEPTED BY THE STATE BOAflD
Ily Ava., St Paul. MN SBJy{.,?,A?7?^ "? UNLESS PROPER INSGECTION FEE IS
ENCLOSED.
/?pS REQUEST FOR ELECTRICAL INSPECTION
? ^??^ 0 See instruclions tor compleM1ng ihis form on back ol yellow mpy
4? 1
'°! J "X" Below Wack Covered by This Request
es-ooooI-oe
ew Add Rep. TypeofBwldmg pAilancesWired EquipmenfWired
Home Range Temporary Service
Duplez Water Heater Electric Heating
Apt Bwlding Oryer Other-(Specify)
omm./lntlustrial Furnace
Farm Air Condrtioner
//Q
Olher (si Conhatlar5?L{? m?e?rk?s,?I?? ?z,?°v/'?J ? c/,?
?/6C(F?'?'?' ?/Y /r`r T L??/
Compute lnspecfion Fee Below: G/("
d Olher Fee # ServiceEntrenceSrze Fee # Circuns/Faetlers Fee
Swimming Pool 0 to 200 Amps 0 to 700 Amps
Trensformers Above 200 _ Amps Abo 100 _ Amps
Signs Inspecmr's use ony', TOTAL ?'j
Irrigation Booms
? •?
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORD ED ?ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby
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ove
ns ection has
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been made. Final I DBt9?
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OFFICE U6E ONLY
:his repuest voitl 1B manihs hom
2 6 4- 6 6 5 0 OFFlC USE ONLY Tlysreqwsl mIE i B manths from voLdanon dare prinicd in Ihis box _?a ^
PLEASE PRIN7 OR 7YPE
Reqoest Dak Rovgh-in mspeclion reqmredT El-fes ? Na Inspetlion Olher Than Raugh.lm Q Reody Now ill Call
S _qi6r ? (.0 (Yoo must mll the inzpacror when ready) Cate Readp
I, [y7?licensed mniracior ? owner hereby reques} inspedion af the above elechical work at:
Job Pddrws (Stree; Box, or Rook No.) Gry Ziv Code
-Zqco in_ r) AV- cvjv_?
Semon No Townzhip Nome or No Range No. Fire N. Counry
DP.
Orcupont PMirc No.
Powe. Supplier Mdress
Eledtlcol Convacror (CompanY Name) Conhaclor Lceme No Masbr lic. No. (PIoM EIeC Oniy)
"? • ?3?a0
Moiling dmss jContmtlor or Owner Pe rming Insmllofion?
AuIhorixed SigrwNre nkatlar rtning Insmllafi Phone No.
^
EB-OO001A-106%95 STATEBORHDCOPY•SEEINSrHUCT10N50NBACKOFYELLOWCOPY
I? I I REf?UEST'FOR ELECTRICAL INSPECTION°5??
Minnesota State Board of Eleclricity i
1821 University Ave., RmS 128, t. Paul, MN 55104 2 6 4 M66-1-11151711 1* Phone (612) 642-0800? 9? ?•
x Apf. Bidg. Other: New Addn
trial Farm Remod Re air
iot ff Other:
e E lec. Heat Tem . Service
"X" above !he work covered by fhis requesl. Enter remarks in fhis spoce and on the 6ack oi the white copy only.
Colculafe Inspedion Fee - This Inspechon Request will not be accepfed without the correct ke:
Olher Fee # $ervice Enlronce Sae Fee 3F Ciraiih/Feeders Fee
Mobile Home Park Sfall 0 fo 200 Amps 0 to 100 Amps ?
$freaf Ltg./Traffic $ig. Abov O Amps 3 A6ove 100 mps
Z TransformedGenerator INSPECTON'SUSEONLY TOTAL /q
$ign/Oufline Lig. Ximr.
Alarm/Remote Control
Swimming Pool I hemb wrfi Mat I ins ihe d amllaeo ed h' e daW shkd
Irrigation 800 m 0.oughln
?
$pecial Inspection ?
Inveshgative Fee Final Dula _ "2 „
?b
THIS INSTALLATION MAY BE ORDERED DISCONNEC D IF NOT COMPLETED WITHIN /B MONTHS.
I II II I?? ?II fiEQUEST FOR ELECTRICAL INSPECTION
? Minr,esota State Board of Electricity
? 1821 University Ave., Rm. S-12B, t. Paul, MN 55104
* 0 2 6 4 6 7 2 7* Phone IR+?I 642-0800 ?O/?6 Z?.d
Home Apf.8ldg. rnei: - New Addn
Commercial Indusfrial Farm Remod Re air
Air Cond. Hig. Equip. Water Hir. Load Mgmt Ofher:
Dryer Ron e Elec. Hea} Tem . Service
"k' a6ove fhe work covered 6y this request. Enter remarks in fhis space and on the 6a<k of the white copy only.
r? w>.?-s.T ??a??..o • cxaT
Caltulate Inspection Fee - 7his Inspection Request wdl nof be occepted without the mrrect fee:
Other Fee # Service EMrance Size Fee 3F Ciwih/Feeders Fee
Mobile Home Park Stall 0 fo 200 Amps 1 141 0 to 100 Amps
Sireat L}g,/rraffic Sig. Above 200 Amps A6ove 100 Amps 14°O
Transfortner/Generafor INSPECTOR'S USE ONLY TOTAL
Sign/Outline Lig. Xfmr.
Alarm/Remote Control r ?
Swimming Pool ?
I herz ceni Mat 1 ins I in I fi b tha da a skkd
Irrigafion Boom Rough-In f Do
Special Inspedion
Inves}igative Fee Firwl ?
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IP NOT COMPLETED WITHIN 18 MONTHS.
2 V T-61 Z [T l This requut void 18 manths hom wlidalion dak pnnf? Ihis boZ
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PLEASE PRINT OR TYPE
R,oest Dute Rwgh-in inspMion requircdY m ? N
!? Inspecfion Olher Than Roogh-In: 0 Ready N. i? Coll
ryo? mo:r wll the n:peeor whe
y) Dak Rmdy
I, (g'fcensed conhador 0 owner hereby request inspedion of ihe above eletlrical work af:
Job Pddrcsa (Street, Boa, o. Boure No )
? Gry Zip Code
Section No Township Nome or No Range No. Firc No. Goonry
Occupont Phon< No.
D ?
roym, su Piie, naare,,
Elecfiml Comrador (Compony Nome) Conkaclor Ilcenu No. Maaler lic Na. (Planl EIM Only)
L G
Maili?g drosejConkodororOwnerPedoimin Installahon)
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AulFwnxed SignaNre ?C r r O»n arforming Insmi n) Phane No.
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EB-00007A-10 6/95 1 STATEBO'AiDCOPY-SEEINSTHUCTIONSONBACKOFYELLOWCOM
IIII II II I?I III II I I II? ?I II REOUEST FOR ELECTRICAL INSPECTION4? 45qii
Minnasota State Board M Electricity 2 7 3 3 1 6 0 Phone (812) 842-0800 m. S-728, St. Paul, MN ssioa
0 ?Home Duplez P.pt Bldg. Olher: ' New Addn
Commerciul Indushial Farm Remod Re air
Air Cond. Htg. Equip. Water Hfr. Load Mgmt Other:
D er Ran e Elec. Heat Tem . Service
'R" above the work covered by ihis request Enter remarks m ffiis spoce and on the back of the whi copy only.
Cakulate Inspec(on Fee - Thu Inspeclion Requesf will not be a<cepted withaut the mrcect fee:
01her Fee # Service Enhance Sae Fee # Circuih/Feeders Fee
Mo6ile Home Pork Stall 0 ro 200 Amps 0 fo 700 Amps
$free} L}g./Traffic $ig. Above 200 Amps bove 100 Amps
Tronsformer/Genem}or INSPECTOR'SUSEONLY TOTAL
$ign/Oufline Lig. Xfmr.
Alarm/Remote Conhol
C
?i
$wimming Pool i hareb mnJ mm i;ne
;U ecmmi insmllanon deecribed hemin on the daks smmd
Irrigotion Boom Rough-In Daro
Special Inspedian
Invesfigafrve Fee Finol
' Wle
x?
THIS INSTALLATION MAY BE ORDERED DI NEtTED IP NOT COMPLETED WITHIN 18 MONTHS.
2 7 3- 316 OfFICE SE OHLV This rpues, vaid 18 monMs fmm voLdanon date pnnred in tho boz
a 00
5?
PLEASE PRINT OR TYPE O
Reqoest Doh
Rough-in inspenion reqmred2 ? Yes No
InspMion OlherThan Raugh-In[3 Ready Now Will Gall
(You most call the inspectondien reody)
I Dah Ready:
licensed confractor ? owner hereby request inspedion af the above elecfri<al work af:
Job PAdress (Sxen, Bos, or RoWe No.) (za Ciry Zip Code
d?1 "Y.6 m4k o
¢ 41, .iS/ T?
Secnon No. Township Name or No. Range No Fire No Counq
Ocwpant Phone No
'.. G/ Z) Lc9Co-//GS
Pawer Soppliar Address
Elecfiwl Conlrotlor (CoPi Nome) Convotlor licenu No. Moaler 6c Nn (Plant Eled. Only)
r.AG.\ c.cc?a.sgo
MailirglWdress jCommdor ar Owna Pedortning Imbllotion)
W L?iN& E . 55/Z1
/wPoonzdSigrwNre (ConlroWro Ins Ilaeon 1 PhaneNa
a. 6 a "- 1rs8
EB-00001A10 6/95 5fATEBOARDCOW-SEEINSTRUCTIONSONBACKOFYELLOWCOPV
3 2 5° 4 4 0 E OFFICE E ON Y Thrs requeat .oid IB manthslrom mlidonon dah pnnted in Mis boa
io, jsG G ?o.s's
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co
PLEASE PRINT OR TYPE
Requea Date Rough.in imv?on required2 Inapecnan OIFzr Than RougA-In [] Ready Now i 1 Coll
I ` k-I "9 (' IYau mast coll the impeMr w
hen rmd?? DaM Ready
I, Lyucensed coniractor ? owner hereby request mspedion of }he above eleckical wark at:
Job Pddmss t3bee1, Boq or Rouro N. I Ciy ' Zip Code
G?' Z
$Mion No. Tawnship Name ar No. Range No Fim No. Coonry
?
Occoponf Phone No.
{. s
PowerSu plier
? Addrme
Elednml Contraeor (Campany Noma) Comraeor License No. Masmr Lic Nn (Planl Elect Only)
Gi. - C?. lG 3
Moilmg /ddnss (Conhutloi or Owner Perf rming In?lollanon)
7 l03 AmuIi-JyGeLj Me, ov, A 5543M
tlorar mirg Inzwllati
Aolhonzed Signafure Phone N.
;
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EBOOOO1h10 6/95 STATEBOAROCOPY-SEEINSRiUCTIONSONBACKOFYELLOWCOPY
i IIII (IIIII II) II.) I I II I II ?I I?II ?? EST FOR ELECTRICAL INSPECTIONC04F' -
ta State Board of Electricity
? 1821 University Ave., Rm. S-128, St. Paul, MN 55104 -
* 0.3 'tfi 4 4 0 6* Phone (612) 642-08001D/My'6, 2S40k
ljpme Duplex Apt. Bldg. Other New Addn
Commercial Industrial Farm Remod Re air
Air Cond. H}g. Equip. Waier Hfr. Load Mgmt. Other:
D er Ran e Elec Heat Tem . Service r
"X" above fhe work covered by Ihis request. Enter remadcs in this spoce and on the bock of ihe white copy only.
Calculate Inspecfion Fee - This Inspedion Request wdl nol be amepfed wdfioul the mrrzd fee
Olher Fee # Service Entrance Size Fee # Circvits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Lfg./TraHic Sig. Above 200 Amps Abo Amps
Transfarmer/Generafor INSPECTON'SUSEONLY T T? ?
Sign/Oudine L}g. Xfmc ?
Alerm/Remote Conirol
Swimming Pool i hareb ?m +hot i in: ed ?he ie?m m?o? dnm6ed hem?? on me dmes sroied 1
Irrigation Boom Rough-In ociv?y
,
Special Inspedian
Investigative Fee
F??al 5t
?
Duie
THIS INSTALLATION MAY BE ORDERED DIS I ED WITHIN 1 MONTNS.
Request Dafe
9 Fre o Rough-In laspection qmretl
(YOU m?u.,st?Gell mspeclor M1en ready)
'
? Inspeaion Otner Than Rough-ln
? Ready Now ?/?II Nohiy Inspeclor .
D {.
Vee
N. Date ReaG
IEa4rcensed contractor ? owner hereby request inspection of above electrical work at:
Job Address (Sirae[, Box or Roufe No ) City
Uo G ORw. ?A
Section ryo Township Neme ar No Renge No. County
Occupanl(PRINT) Phone No
FAS. - M" ?=G?a-kA?- 3ulFPoC[. G
Powar Supplier ACtlress
Electncal Contractor (COmpany Name) Con[radar's Llcense No
? GP
Maibng Atl ress (COnVacror or Owner Making siallation)
A .Z S. ? -
uthqnzetl SigneW (Conlrector/Owner Meking stalleVOn) Phone Number
'-1 `i'Vc-_)
MINNESOTA STATE BOAND OF ELECTqICRY THIS INSPECTION PEOUEST WILL NOT
Grlggs-Midway Bltlg. - Aoom 5428 I II II I I I I II I I? I II ?? ?I BE ACCEPTED BV THE STATE BOARD
1821 Unlversity Ave., St Paul, MN 55100 UNLESS PROPEfl INSPECTION FEE IS
Phone(61P)8A2-0800 ENCLOSED.
G.-?[( C?? REOUEST FOR ELECTRICAL INSPECTION
Ooo Sea inslmctions for completing Ihis fortn on back ot yellow copy
"
"
8e/ow,6Vork8overed by This Request
X
Ne Add fiep Type of Building Appliances Wired . Equipment Wired
Home Range . Temporary Service
Duplex Water Heater Electric Heating
Apt. Bwlding Dryer Load Management
Comm /Industnal Furnace Other (SpeaSy)
Farm Air Conditioner
Othar (spealy) Contraclor's Remarks
Compute Inspection Fee Below.• t
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps ? 0 to 100 Amps
Transformers Above 200_Amps Above 100 _Amps
SIgfIS Inspactor's Use Only TDTAL
Irrigation Booms ? G
F
S ecial Inspection `7 r?
L y
Alarm/Communication THIS INSTALLATION MAY IF NOT
?91CONNECTED
Other Fee COMPLETED WITHIN 78 MOMC S:
I, tha Electrical Inspector, hereby
tif
th
th
b
i
i
h Rough-in
' Date,./
?
cer
y
ove
at
e a
nspect
on
as
been made. Final Dete
OFFICE IlSE ONLV
This request voltl 18 monNS trom
Th,saequesl vo'tl q?
18 momhs (rom
? . 97 8 53
1?)uest pa ta '
,^..
? Fire No. Rouph-in Inspectmp
Ne?retl? /
?qu
yes LXXo ?ReaGy Nuw <II Notify Ins
Oec-
ror When Readv
censedrElectncal Contractor 1 herebv repuest insoeefion ol above
?' '
? Owner ? eleetricel work inatelled at:
Sireet Address, eox or floute Ci???
ect on o. Township Name ar o. Ran No. Co ty &
OccuDan (INT) /1 Phone No.
?
WkAu L ?
Power uppl Atldress
Ele rica1 Convr ICompan? Contractor's Licons'No.
Z J
Ma ling Atldress ICo «actor or Owner Makin Instailat?onl
s? ?s s D?
.?1 d Si ature I on ctod w r akrng Insta lationl Phone Number
I
KNNESOTp STATE BOARO OF ELECTIIIGITV THIS INSPECTION REQUEST WILL NOT
Gripge•Midwey BItlB• - poom N-791 BE ACCEPTED BY THE STATE BOAHD
1827 Univeraity Ave.. Sf. Peul. MN 56104 UNLESS PNOPER INSPECTION FEE IS
Phane16721642-0800 ENCLOSED.
71?U%REQUEST FOR ELECTRICAL INSPECTION
? Seo iostruetions /or eomDleting this fmm on beck of Yellow coOY.
?? q? R G a "X" Below Work Covered by This Request
w? adaTNep• ?Type ol Bu,ItlmO APClioaces WireA Edu,pmant Wired
?1- I --T Home Range Temporarv $ervice
N F SarvicaEntrenceSme p Fee Feeders/5ubfeede.s IX Fee Cncwts
? U to 200 Am s 0t230 qm s 0 tn 30 Am s
Above 200 qm " 31 to 100 Amps 31 to 100 q y
Swinmmg Pool Above 700_Am s 461ve 100_Am s
Transiormers rngaLOn Booms Fee
?
7,,,Z I, Ne Ela?irjtal?
Inspector, heroby
?
Finel +
? carlilv ?he? the a4ove
naoe<non hes been
/,/? ? mada.
??a7/9. o 5il <0- Y?51e-e
P 48716 ;? ?
Requesl Dflte Fire No. Rough-i specUOn
1 Raquire ? Reedy Nowefiall No4fy Inspeclor
p yys ?p VTlhen Reatly?
k9.liCensed contractor ? owner hereby request inspection of above electrical work at:
Jab Adtlrees (Slreet, 9m, or Route No ) CM1y
Saction No. Tamship Neme w No Range No CouMy
Occupant (PRIIJn Phane No.
Poxrer Supplier Adtlre
Eleclri or (Company Nama) Conhaclort licenae No.
z: O ?Y ?O
Ma nq AEdress (
r er Malung I a1bn)
? C
Au onzed Signetura (COnVaclor Ma Insiallatron) 1 Pooire Number
7
MINNESOTA STATE BOA OF ELECTRICRY THIS INSPECTION REQUEST WILL NOT
Origgs-MlGwey Bitlg. - Noom 5173 BE ACCEPIED BY THE STATE e0AR0
1821 UnFrersity Ave., SL Geul, MN 55709 UNLESS PROPER INSPECTION FEE IS
Phone (812) 662-0800 ENCLOSEp
?Fo
F- 8716
/ /j
REQUEST FOR ELECTRICAL INSPECTION
? See inaW'tions for mmpletim7 ffim form on back of yellow wpy.
"X" Below Work Covered by This Request
E&00001-07
'? 9?8sy1
ew d Rep. ? Typeofemiding AppliancesWired EquipmerrtWired
Home Range Temporary Sernce
Duplex Water Heater Electric Heating
Apt. Building Dryer Olher (Specify)
m./lndustrial Furnace
Farm Air Conditioner
Oiher (apedry) CoriVeclorffi Remarks;
in. // a??XY o.^4 a ??S
Compute Inspectian Fee Below: 45
# Other Fee # ServiceEniranceSize Fee # Cimuits/Feeders Fee
Swimming Pool 0 fo 200 Amps 7 o to 100 Amps
Transformers Above 200 _ Amps Amps
Signs Inspectorg U. Onty. TOTAL
Irrigation Booms
Special Inspection
Alarm/Communication
Other Fee
I, the Electrical Inspecto5 hereby
c
f
rt
th
t th
ti
b
h R°ugna„ oa?e
i
y
e
a
e a
ove inspec
on
as
been made. F!" oa?a
OFFlCE USE ONLY
This requBSt witl 18 rtwnths irom
ThIstiroquest void
mo 7?
?9h6966
Heque??78Le ' Pire No. Rouq -in InsOecvon
Req iretl7 ?fleady Now W?II Nolify, InsOec-
? ?es ?No tor Whan peady
Lpcensed Elacvical Contractor I heraby reqeeaf insvection of ebove
? Oalner electrical work inetelled et:
She6t Address. Boa or Naule No.
-0,400 Z-01VE
AI24LV,1 Gty
ectlon o. TOwnship Name o! No. HanBe NO. Counly
n
cc?pu t IPqINTI ??? ? Phone No.
Power Suppher Atldress
S
Elecencal Contra<tor ICo pany Namel Contra,tor's License No.
??OnS ??6CT?l? c
MadinO Atldress ( ntractor or O ner Making Installationl
Ue s s U
, ?
A ' ed SiBna[ure IC ra ?/Owner MakinB InstallaUOnl Phone Number
?
MINNESpTA STATE 80AR0 OF ELECTNICITY THIS INSPECTION REQUEST WILL NOT
6r,BY=•Midway BId9• - Room N•191 0E ACCEPTED BY THE STATE BOAND
7821 Univeraitr Avs.. St. Peul, MN 65104 UNLESS PNOFER INSPECTION PEE IS
PhOne (812) 642-0800 ENCIOSED.
?? REQUEST FOR ELECTRICAL INSPECTlON Erys-o/oooi-osn
0 See inatrueqons br comDleti'q Mis fwm on back oi vellew copV r Cs'??`?
"X" Be/ow Work Covered by 7his Request
_A .?? . -?
WeslAddl Reo. Tvoe ot Bmld,na T Aoolieneee Wiretl Epuipmen. Wirea ?
Farm
oner
p Fae Service lintranceSi.0 !1 Fee' Feeders/Subleeders p fee Circuita
/ 2 m s 0 to 30 Am s? 1? 0 M 30 Am
_AmPs , 37 to 100 Amps 31 to 100 Amps
Swimmin Pool Above 100_Am s Above 700_Am s
Transiormers Irn ation Boorrs Fee
Signs I I I Speciallnspection
4
certify that <he above
+nspection has been
repuest vOltl 18
This repuest void
18 mpnths.((ro1m
0 1U 23O 5?,/.@1/
fleques? Oat?p,p L?`-
1
/?
'
? fire No. Rouph-m suecuon
A.e,i red, ?/?
OReatly Nuw y??• ill Nnlify Insoec
`
C V ?No
¢9yes / `?o
r When ReadY
M9 Licensed Elecvical Convactor I hereby repuest msoeciion of above
Q Own[r
elecbical wolk msteliad ab
Str¢et Atldress, eox or poule No. C.iy
Z14cz? L:me FJ,4K C-AC-rA,,4
ecvon o. Township Name or No. Renge No. County
J) 13k?'iTA-
Occ GaotIPRINTI 1 ?
? Phonc No.
f
oR.TavJesr 4t4zurijcS E3 tD(:,- E
Pow'er Su00her^
w/? SP cW
• Address
Elje?ctncal Contractor (Comprany
N
am
e)
1 Contracior's Li
c
ense No.
?
?
J
?
T NF??I?? S Gq.r.C..i?K.a? /
?
?
Maihng AdJress IContrector or Owner Makmg Instailatmnl
q t--1 S''11' 4J& S_ lv'? PL-?
Autho ¢ed SiAn
a
t
ureIC
ontrr/Owner
InstallatmN Phonu Number
?
/
J
n
?
W?.c.FL 3 ' 8711,-?'ti
MINNESOTq STATE BOAND OF ELECTqICITY THIS INSPECTION pEQUEST WILL NOT
Grie9s-Midway Bltlg. - qoom N-191 BE ACCEPTED BY THE STqTE eOAND
1821 Univarsitv Ava.. SL Peul, MN 65704 UNLESS PXOPEN INSPECTION fEE IS
Phona(812) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION L EB-00007-06
{-. 11P See inairarbons for comoleLng this brm on Eack oi yellow coFV(? ?'y?r?
82385. X` Below Wak Covered by This Request
Nevi FAd Reo. Tvpe ol BuilUmg ApDhuncen Wved Equ,umen[ Wiretl
Home Range Temporary Service
Duplex Water Heater Lighnny Fixtures
Apt. Bwlding Dryer Electnc Heatm
Commeraal Bldy. Fumace Silo Unloader
Industrial BIAg. Air Conditioner Bulk Milk Tenk
Farm inr. oeci v 0m, tSOC,,W?
tTe Sueu y mor O, n,,r
Cbmoute lnsoectron fee Below
N iee Service EnfrenceSi¢a H Fee Fexders/Subieaders IX Fee Circwes
0 to 200 Am s 0[0 30 Am s 0 ta 30 Am s
Above 200 qm>s 31 to 100 Amps 31 to 100 A s
Swimming Poal Above 100-Am s Above 100_Amps
Transiormers Irrigation Booms Partiel.'Other_F.ee_
Signs $UeciallnspecUOn
S
l ?
OTALFiEE L
Hemarks '
j.(?„ ..1
Nough"^ - ' ? - - ? 1e / . the Elan¢al?
%/
???Q Inspecluq he,oby
certify tMt the ebove
Final
• / D'ite
!s s'F-C( inspechon hes been
meaa.
tttla rBpuest voltl 18 montlis irom
This request wid ?/G ?.d
18 months Irom d 7SJ
D 8235 2 /_ ?3/ AL,
,X- 91-52 ?
Re?uest Daie ire No. RouPh-,n Ins ,tion
ReQUrted?
I
ll Nobty InsDec-
[]ReaAy Now?Wi
Yes ?No r
?o When ReatlY
KLi ensedfElecVical Convactor I hereby rapuest inspection ol above
Owner elechwel work inslalled et
1
ss, eoz or Route No.
Stree[
AdAre Lily
w
0 / L?/?O //K /?
?// i l
ecuGn o. Township Name or No. Range No. County
?
Occu ant (PqINT) Phune No.
/
C..?
Power $upplier /address
I ?ncal Conuactor (COmpany Name)
E Con[ractor's Licenqe No
.
l?L4i2SOr1s f1?ZlG D 0 --D
MpaJm Addres nVa?cytor or Owner Makin Ins,allatmnl
s 1 ?
?
?
r
0
`S /;?
f/7
57 4
?
0
!2l/.?• c6
re lCoihner Making Inst.?IlaLOnl
Authq?ir Phune Number
???
// lJC/ 3a? ?T6
MIfUJESOTA STATE BOAND OF ELECTRICITV
Grig9s-Midwey Blde. - Aoom N-197
1027 Universitv Ave.. 56 Veul. MN 56104
an....e raivi anztmnn
TMIS INSPEGTION PEQUEST WILL NOT
BE ACGEPTEO BY THE STATE BOAFD
UNLESS PHOPEN INSPECTION FEE IS
ENCLOSED.
7 Jbr/5V REQUEST FOR ELECTRICAL INSPECTION es-oo'o/oi-os,
/? I, See inetruclions for completing this form on back of yellow copv. FfSyG ??
18,2 3 59 s. "X" Below Work Covered by 7his Request
AAd R? Eme
' Aualmncee Wved Eqmunlem WireA
Range Temporary Service
Water Heater Lic?hLny Fixtures
Bui
lding
? Dryer Electrro Heatin
M
Bldy. Furnac Silo Unloader
dg. Air Condrtoner Bulk Milk Tank
Ot^e. o"':' v
v Otner Otho,
omoute Insaectron fee Below
p ` Fae ServiceEntranee5ize
B Fea Fexders/SUbfeeders # Fe.e Cvcurts
U to 200 qm 5 0 to 30 Am s • 0 tn 30 Am s
Above 200 qmps1 sW 1 ,&7,00 31 to 100 qmps 41 31 to 100 A s
Swimnung Pool Abave 100_Am s Above 100_Ain s
Transtormers Irngation E3ooms P- ' er ee
$igns Spedal Inspection S N/A
T
/ /f
Haueh.in I. e Elachi
nsp , ereby
? p ertify thet the above
Final ? ingpectioii hes been
? meda.
Ttile reGUast vold 18 montlis irom
