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P - 80015. REQUEST FOR ELECTRICAL INSPECTION Minnesota Board of Electricity 1-396-136 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 — � (651) 642-0800 TTY/MRS 1-800-627-3529 www. elec tricity. sta te. mn. us Identify the work covered by this request: 0"aEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Above 800 Am ere � $75 CIRCUITS / FEEDERS 0 to 200 Am ere (� $5 Above 200 Am re � $10 ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS Each S stem Device or A paratus �$.50 ADDITIONS TO THE GENERAL FEES MULTIFAMILY DWELLINGS iPER UNI11 � XCEL EPJEROY SAVER'S SWITCH to 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 Trips � $20 FOP INSPECTOR USE ONLY ROUGH IN fINA� N!$PECTION TOTAL FEE total fee is $20} DATE J�-_S� FOR OFFICE USE ONLY ����11�I1�I�II�N�I��I��II�1�� �l� ��s� * 1 3961 362* c�0-Su Reque���2 Rough-in fnspection Required'? ❑ Yes I�No Inspection Other Than Rough-in: I� Ready Now ❑ Will Call You must call the inspector when ready! Date Ready: I certify that I am the �l LIGENSED CONTRAGTOR ❑ CAMPANY ❑ OWNER and hereby request inspection of the electrical work at: Job Address {s�, eaX�a� ao�ce No. aVE NE c�i� ��Y zP coae �3a 1 Section Township Range Fire No. Counry Ai�a �cU KUHLMEYER ERIKA L � � Phone Power Supplier Address XCEL ENERGY Electrical Contractar / Company Name Contractor License Number Master license Number HUNT ELEGTRIC G4RPORATION CA 00883 Mailing Address {Cantractor, Company or Owner PeAormingJnstallaYwn) 2300 TERl31TORIAL RDAD , SAINT PAUL, MN 55114 Authorized Signature (Contractor, Company or Owner Performing Installation) Phone � ,'�� 651 64�-2911 EB-00001A-13 7/i/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY