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P - 75525` - 'v REQUES� FO� �t�CTRICAL INSPECTION 2° 0 6 4���� � Minnesota Board of Electricity 1821 Universily Avenue Suite S-128, Saint Paul, Minnesota 55104 (651) 642-OS00 TTY/MRS 1-800-827-3529 www.electricity.state.mn.r.rss Describe -' e back of the white copy ff necessary - the covered by this re.qu�st ^ 0 /1 11 CJuL�� GENERAL FEES Outdoor Liahtina Standard f�a $1 IALARM, CAMMUNICA170N, REMOTE COP1TROl CIRCURS, CIRCUITS OF LESS THAN 50 VOLTS Each Svstem Device or Aooaratus (a� 5.50 Un� @ Fbfilre WI�WUWUWUIUIIIuuWUW��I� �0641221 Sup lemerdal Fee @ $20 Tiansfortners u to 10 KVA �c $10 TiansFomrers over 10 KVA c$ 20 Tiansformer / Power S I for Si rts / Outl'me ' $5 ONE 8 TWO FAMILY DWELLINGS, EACH UNIT Inciudes the Service and/or Power Supply up to 500 Amperes, M Circufts and Tvro Inspecfion Trips Each Dwellir�g Unit @$80 � ReinspecUon Fee @ $20 TOTAI (minimum total fee is nnsars�aw I Irereby certlfy tlmt I Irepected the elecMml aa��rw u�cr� �/`� oautm�aeat�mot�n �- hefehl on the detes 8feted: L• �� . �� ��9 � �� S�F� EUSEONLY 4 2007 ��7�/� o�- ���^ f I�� I Rough-in Inspedion Requhed7 �❑ No I nspacdon Other Than Rough-In: � Ready Now 0 WtlI Cell g�_r You muet call the inspector whe � dyl Date Ready. I certiify that I am the ❑ UCENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request ins�ction of the el�hical wi�rk at �ob s�e saee� add�ess e 1 i. � �_ _ ��i- . 1� e � � �� F� � 1 �, r� � ��. f� � I .�i�: Q ■ � � or �■