P - 76492REQUEST FOR ELECTRICAL iNSPECTION `
1-929 830 `M�`
� Minnesota Board of Electricity
�' 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 �'
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��'� (651) 642-0800 TTY/MRS 1-800-627-3529 www electricity state mn us
�escnbe usi q�the 5ack of the wh� copy rf necessary the work covered bv this renuPCr
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
3 to
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i apeuai mspecnon d 5.37 per Mile �—
THIS INSTALLATION MAY BE ORDERED DI:
illii IIIiI IIIiI IIIII IIIII IIIII IIIII IIIII �� I�
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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
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�t i
NOT
total fee is
fhe electrical installatlon described herein on the �tes staled:
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wr�t � to WITHIN 12 MONTHS
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Rough-in Inspection Required? ❑ Yes o Ins ction Other Than Rou h-In:
/ v`a 7� �� � 9 ❑ Ready Now ill Call
< You must call the inspector when ready! Date Ready: