P - 77744"] REQUEST FOR ELECTRICAL INSPECTION �
1�� 1�- 3 5 8 3� Minnesota Board of Electricity ;r -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-6273529 ���1��i��.electricity.stale.mn.us
Describe -using the back of the white copy if necessary - the work covered by this request:
EXCEL ENERGY SA�JFR'S S�JITCH
GENERAL FEES Outdoor Li hting Standard @$1
SERVICES / POWER SUPPLIES Traffic Siqnal Standard (a� $5
0 to 400 A
401 to 800
Above 80C
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Apparatus @$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNITI
Unit @
Lighting Retrofit @ $.25 per Fixture
Center Pivot Irrigation Boom @ $4L
Manufactured Home Park Lots f� $
Transformers u to 10 KVA $10
Transformers over 10 KVA $ 20
Transformer I Power Su I for Si ns I Outline Li htin $5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Additional Ins ection Tri s $20
Investigative Fee
Reinspection Fee $20
TOTALFEE
(minimum total fee is $20)
iHISAREAFCRINSPECTORUSECNLY L v�.
I hereby certify that I inspected the electrical installation descnbed herein on the dates stated:
Special Inspection @$30 per Hour tXP1RE0 "�NpO11�'—
Special Inspection @ $.31 per Miie
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12
IIII II I(i II I�i II III il III u fll II III II �I II III I IIII
1 7 7 5 3 5 8 3
L"_� � Q �� �
Z�oS � o�a 20 �
���, Date: I Rou h-in Ins ection Re uired? ❑ Yes
, g p q Q No �'� Inspection Other Than Rough-In: � Ready Now ❑ Will Call
'� '°�� ��-p05. .__�ou must call the inspector when ready! __�te Ready:
I certify that I am the fj�l LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER
----- _ _ _- — - ----------- — _ _ _ _
� Job Site Street Address
, ia�5 64TH av� r��
wner/Occupant Name
ROGIGH DANIEL U
and hereby request inspection of the electrical work at:
Ff:IDLEY
I, Fire No. II County
, a�o�a
tPlease Provide Two (2) Phone Numbers
�\ / \ �
; Electrical Utility !I Electrical Utility Address
' XCEL EhIEkGY �
� ----- - - ----- —� -- -----
�,. Contractor / Company Name ��. Contractor License Number ' Master Electrician or
'. I License Number
'��__HUh1T_ ELECTFIC COf;F'OfiATIOh! _ _ CA_0088�.�
I Mailing Address (Contractor, Company or Owner Performing Installation)
'; L�00 7EF�F�ITORIAL I:OAD, SAINT F'AUL, hIN 55114
I Authorized Signature (Contractor or Owner Performing Installation) � � Please Provide Two (2) Phone Numben
I !'�et %�et�dis i �i51� 54b-�911 (
INSTRUCTIONS ON BACK OF YELLOW COPY BOARD OF ELECTRIGTY COPY
)
Limited Technician I