P - 76222REQUEST FOR ELECTRICAL INSPECTION �`�°� ,
� � � � � � � q, 7 � nesota Board of Electricity ..�,
,���-�_ � s 182 University Avenue Suite 5-128, Saint Paui, Minnesota 55104 •
� ) 642-0800 TlY/MRS 1-500-627-3529 www.edectricity.stade.mn.us �""�
IlacrriM�.i i }hw hark nf Tha whifw mnu .. carv _ fhw wnrk rnvamrl hv thic mni �acf •
401 to 800
A�ve 800
UITS, CIRCURS OF LESS THAN 50 VOLTS
Each System Device or Apparatus @$.50
ADDITIONS TO THE GENERAL
fIFAMILY DWELLINGS (PER UNIn
3 to 12 Units @$50 Per Unit
Each Addi�onal Unit @ $25
OTHER ADDffIONAL FEE:
Lighting Retrofit @ $.ZS per Fodure
Center Pivot Irtiaation Boom (�a. $40
Includes the Service and/ar Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Additional Inspection Trips @ $20
InvestiaaWe Fee
MAY BE ORDERED DISCONNECTED IF
total fee is
electriml InstaVatlon descnbed hereln on the dates sfated:
C, e e�� � '` o�� � �(
� �� c,���r;� �;�e or� 4
iI�III�IIIUII���IIII��II���II��IIII���O�l� �� JUN � 9 2001
21606470 ��'`�-�/��°
Date: /� Rough-in Inspection Required7 ❑Yes No Inspedion Other Than Rough-In: R y Now � WN CaU
AY/ D� You must call the inspector when readyl Date Ready: � O
I certiiy that I am the LICENSED COM'RACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical arork at