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820 Lone Oak Rd - Electrical Permitsoooot-os 51$-7 REQUEST FOR ELECTRICAL iNSPECTION . e6- 7so// " , See instrucGOns for completing ihis iwm on b»ck of yellow copy. _4 R?,//.2X- Below Work Covered by This Request D17R lNaWlAAdI Rep.1 Type ol Building I AppliOntes Wired I Equipment Wired I Duplex Water Heater Li,yhtin,y Fixtures Apt. Buiiding Dryer Electric Heatin Commercial Bldy. Fumace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm olnt?r necirv Dtne, isne?,?ry1 N ee ServICeEMfenceSize M Fee PeederslSubfeeders a Fr,e Circuits 0 to 200 Amps 0 to 30 Am s AO 0 tn 30 Am ps Above 200 Amps 31 to 100 Amps 31 to 100 A s Swimmfng Pool Above 100_Amps Above 700_Amps Transiormers (rrigation Fiooms Partial-Other Fee L_1 I Signs Special Inspection js?/ ?I TOTAL?I Rertwrks ' / . rI i I ---° - I I. n sihPect ree lectric I by certity thet the above Final ^ ?? r A D? ?dection has been reques[ voiA 18 This request void ?/?S/? r? 18 mpnths (rom ? - DI 71 8 3 z_ Iv Ad -7 soi/ Bequest Date ?/??? Fire No: Rouph-in InsUec'tion Re quired? jAeady Nowill Notify. InsPec- l"or Wh n R ad ? Yes O No e e y Licensed Electrical Contracmr I here6y request inspection oT e6ove ILJ Owner electrical work installed at: Street Address, Box o?,Route No? ?? So? ?^"w Ciry ' E ecuo?? o. Township Name or No. Range No. Coun OccuGant(PRINT) ? `(YL W:AL Phon¢ Nn. u5?- 7179 Power Suppliei ?D/n-ba'c.a- Address / Electrical Contractor IComp ny me) v ?s-r,.?. ..? ??- ?4c.e?, Contrar.mr's License No. `f03 - 7 Mailinp A0ddrress (Contractor or Owner Makin Installation) !?) Jo S/W 7 Au[horized Signa ure ('CoMractor wner king Installation) Phone Number \ ?? v" - THIS INSPECTION qEQUEST WILL NOT MINNESOTA STqTE BOARD OF ELECTflICITV Griggs-Midwey Bidg. - Noom N-191 BE ACCEPTED BY THE STATE BOARD UNLESS PflOPER INSPECTION FEE IS 7821 Universitv Ave.. St. Paul. MN 55104 Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ?. es-ooo/oi-?os e?{ , See inslructions tor completing this form on beck ol yellow copy. ? U D 66t29 "X"°Below tiYork Covered by 7his Request ewl Add Rep. Type of Building Apoliancea Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lightiny Fixtures Apt. Building Dryer Electric Heatin Commercial Bidy. Fumace Silo Unloader lndustrial Bldg. Air Conditioner Bulk Milk Tenk Farm Oihror peu y MherlSPer.ifyl t er Uncify Other Othur ompute lnspection Fee Below p Fea ServiCeEMrenceSize 11 Fen Fenders/Subleader5 ? Fe¢ Circuit5 L) to 200 Am s 0 to 30 qm s 0 tn 30 An s Above 200 Am ps 31 to 100 Amps 31 ta 100 1 Am s Swimming Pool Above 100-Amps Above 100_AmPS Transformers Irrigation Boorris Partial-"Other Fee Signs Specfal Inspection TOTAL F Remarks aJr. t V / ? ? / /f s e?'I'!ew ?.4ea t Y ?e IM Rough-in ? I?? ? ? e EI ' Inspector, here6y CBrtify lhBt the aboYB Final U+'te inspection has been Q made. Thle reGuest volA 18 montha from (/ CJr C-,C--/'L- ! /vt-{,,,[_: This requesl void ie months from ? 5? 12 9,C o?? ??? e.. ,?•?? // 6VD °o ?nequest Ua1e ? Fire (Vo. Rough-in Insper,tion ReQUired? [:]Heady Nuw?Will Nolify Inspec- ? Yes ? No tor When Iieady ? Licensed Electrical Con[racmr I hereby request inspection o1 above O Z wner electrical work installed ac l Street Address, Box or Route No. q? ? j ? o ? 1 ?p 1 F c{ty -e - ?n ectioii o. Township Name ur No. Ranye No. County OccupantlPRINTI Phone No. Power Supplier ??/\ ? y { N S L Yv p Address Electncal Con[raompany Namel 5'& ?r ?C T Contractor's License No. Mailing Address (Contractor or Owner Makiog Inst on) ?/? T?'o ^Ch V/?'/ ' /?/'/i ??/- / Author' e SiB ture IConir99 tor/Owner Making 1 stallatioa) hone Number MINNESO7p STATE BOqqD OF ELECTRICIZ"y Griggs-Midwav Bldg. - Room N-191 7821 Universitv Ave.. St. Paul, MN 55104 Phone (612) 642-0800 THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED.