P - 77385'7Q REQUEST FOR ELECTRj AUNSPECTJ.UN
1�( O�- 3 4 9 4 Minnesota Board of Electricity� b('� -�f �S `�.` '
❑ 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 �.
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.slate.mn.us
Describe -using the back of the white copy if necessary - the work covered by this request:
EXCEL ENEnGY S�VER'S S4IITCH
GENERAL FEES Outdoor Lighting Standard @$1
SERVICES I POWER SUPPLIES Traffic Sianal Standard (al $5
401 to 800
Above 800
;UITS / FEE
ALARM, GOMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus @$.50
ADDITIONS TO THE GENERAL FEES
@ $50 Per Unit
iBoom @
Park Lots I
Park Sites
Hour
Transformers u to 10 KVA $10
Transformers over 10 KVA @$ 20
Transformer I Power Supply for Signs / Outline Lighting @$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Additional Insoection Trios la� $20
TOTALFEE aD-�.O ����
total fee is $201
that I inspected the elecUical installation described herein on the dates stated:
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THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12 MONTHS
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17813494
', "�j'�(��� � i Rough-in Inspection Required? ❑ Yes �] No II Inspection Other Than Rough-In: [�Ready Now ❑Will Call
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__ __._ ''�i You must call the inspector when ready! , Date Ready:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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'Mailing Address (Contractor, Company or Owner Performing Installation)
��,'�00 TERRTTORIAL f:OAD, SAIf�T F'AUL, �IN 55114
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�Autporized 5 nature (Contractor or Owner Performing Installation) ���Ig�s� royi
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INSTRUCTIONS ON BACK OF YELLOW COPY BOARD OF ELECTRICITV CnPV
io (Z) Phone Numbers Including Area
\ /
Master Electrician or Power Limited l
License Number
Jumbers Including Area
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FR_(1!1!1l11A_1S v � �nnn