P - 78116Cc REQUEST FOR ELECTRICAL INSPECTION
1� J� U�- 912 � Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
❑ NEW REMODEL ❑ ADDITION ❑ REPAIR Describe -using the back of tt�e white copy rf necessary - the work covered by this request:
Convert overhead residential service to undergrou
GENERAL FEES Outdoor Li htin Standard E1
SERVICES I POWER SUPPLIES Traific Sianal Standard � ES _. �
0 to 400
CIRCUITS I FEEDERS
0 to 200 Ampere � $5
Above 200 Ampere (D$10
ALARM, COMMUNICATION, REMOTE CONTROL
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus � 8.50
Additional Unit @
Boom
Fbur
Su �lemental Fee $20 Vt� '
Tr�sfortners u to 10 KVA � E70
Trarisformers over 10 KVA $ 20
Transformer I Power Su for Si ns I Outline Li h6n $5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Tv�ro Inspection Trips Each Dwelling Unit �$80
Fee
(minimum tofal fee is $20) � $30. 50
iH15 N2EA FOR INSPECTpi USE OKv
I hereby cer6ry Mat I inspecBed the electrical inst�la6on described herein on the dates sfated:
INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN
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30•50 -
�4�< <+e�e� Rough-in Inspecfion Required? LJ Ves l� No Inspectiai Other Tha� Rough-In: ❑Ready Now � Will Call
9� �% � Q�f You must call the inspecta when readyl Date Ready:
I certi(y that I am the �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
INS7RUCTONS ON BAGK OF VELLOW COPY BOARD OF ELECTRICIT' COPV E&00001A-14 8.1. 2002