P - 75632P� n REQUEST FOR ELECTRICAL INSPECTION
'�� ��"° ����` � 8121 Unrve � A en e 3urt & 28, Saint Paui, Minnesota 55104 I
i°`'�` ' •(651) 642�0800 TTY/MRS 1-800-627-3529 www.e lectricity.state.mn.us "� "�
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Describe -using the back of the white copy'rf ne�essary - the xrork cov,Qred by this request: �
0 to 400
800
CIRCUITS OF LESS THAN 50 VOLTS
Per
@�
BE
Outdoor
KVA
ONE 8 TWO FAAAILY DWELI.INGS, tn�li urvl i
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits arnl Two Ins�ction Trips Each Dwelling Unit @$80
Fee
TOTAL FEE �/ �p
(minimum total fee is $20) '—'"'
TMSRREA WSPECIORUSEO�LLY
I herebY�� insPeded ��m�allaYOn d�nCrf�d herBin on �� ata�d�. .v
FOF.rFF:C�U�ECi'�ILV �� �-�r-og
, ��I�
I IAI u ul II UI �� II� II��I (I �I u� I� IU .
18204123 ���--�%��j
��I�' � Rough-in Inspection Required7 �� No Inspectlon Other Than Rough-In: ❑ Ready Now �OVN Ce0
fn � vn�� m� irzl ratl tha in_aoector when readvl Dete ReedY
I cerMv that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY �WNER and hereby request irts�Ction of the electrical vuork at