Loading...
P - 75399REQUEST FOR ELECTRICAL INSPECTION ' � _ � 2 0 � � � � � Minnesota Board of Electricity �+m- �' 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.t�s Descrfbe -using the back af the white ca y ff r�essaiy - the work covered by this requ�st: � � $ei'1s�C@. �vBr�Ga�—�uu�er rou� i�F�ov� �lnorv�. GENERAL FEES Outd�r Liahtina Standa na Q1 ✓ICES / POWER 0 to 400 Amoere CIRCURS OF LESS THAN 50 VOLTS iystem Device or ApparaWs @ $.50 ADDITIONS TO THE GENERAL FEES Unit @ CeMer Pivot _ � THIS INSTALLATION MAY BE ORDERED U IIIII�IIIIII�111i�III��III��I��IO�I� 18202820 Traffic 20 ONE & TWO FAMILY DWELLINGS, EACH UNR Includes the Service and/or Power Supply up to 500 Am�ras, All Circuits and Two Inspection Trips Each DweAing Unit @$80 Additlonal Ins 'on Tri $20 Investl ative Fe� Reins on Fee $20 TOTAL FEE �r (minimum total fee is $20) �,�� nag a�a rroa wsae.,� us� ow.v I hereby certlfy that I in�eded U�e electrlcal U�Ilatlon desmbed here(n on the dates atated: �+w onre _ �v �y S"°�,3 t— �7 � � ��� a�� IF NOT COMPLETED WITHI I�C'D �I°��`��`� 20 I ���-C����� Rough-in Inspecdon Required9 �� ❑ No Inspectlon Olher Than Rough-In: ❑ Ready Now 0 Wi0 Ca11� �/� �/�� � You must call tlie inspador when readyl Date Ready. I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY�OWNER and heteby request inspection of the el�trical work at