The URL can be used to link to this page

P - 76853Mmnesota t of Labor and Indus�6y 443 Road Notlh � St. Paul. 55155-4342 �: ,, �� ,-r,r,� ��,, ��,� www. ' .state.mn.u,s Con'tractor R uest for Electricai � RougFNn ir�spedio�, Reqt�d? �U ��' D�- ['.entr.�rfnr n�..e► c..�a..�., w o o--- .� ... ...o}.oa�W� � — ou4'� 1 4 -�L+ '.f ��RIB r-�o� 1��. �. � +� x Teleptwne NunbeKsj _ �3- a �[- 1 8a �Q ��ti- �I ec�-r,.� � �T� IVumber a-- 3Gz�- l� � gv �� Yes �� 'r�� REC'D OCT 2� 2 20�7 Ne11i�9�Associated Structure � il� Rough-In: Ready Now d�de All F�al lnsoer�;r�c (-1 wr� e,.�,sa..� �',.�,r..�� e r�� c � "��` �-- IS.� �- m. �� mr-� Ss3 3� � �i�e nau�►�er .�o�r� co�cc �s«, � � �s � � �. c�,�,�, Fee Calculation New Home or A�oc�d Structu� Exis�g Ho�� Renadet or Addition New uwe�g seNic�lPower supply o- 400 �ripere 1� s3, �w s�w,� S�hl �- 400 ampere � S35 �� PPh� �1- �00 amPere � i60 New SenricelM�awe� S�ply �01- 800 ampere � S6U .._._..�__�-- �- � -- - 30 feedersM.im,ii� _ A � � O� � A� .�f'liCd1�B N� �^"0�°�` ��Y � - 400 ar�ere � %i5 New f�j� ( ) � S6 Eadt � � �1�@ Of �1@f �Bd $h1IC�l� � �^^O�O�"� �P�Y 0 — 400 ampere � i35 � FeedersliC'a�cu� ( ) � �G EaCh �0°� �� ( ) � �2 Each Total (the fee � abore or Zis rnulfipied T�1(Ihe fee cakx�la�ed above or s35 mu�ip�ied bY the manber of reyuired i�spec� �, whichever is �) bY tlie nurnber of requi�ed �sPec�ion trips, v whicNever is grea�er) , � S. �� P�tlon (RB} wYA a iae d f250 or Ises �spie 11 monlhs iro�M 1As flYng dala. 7t1e CorMraclpr me�st 11� g1e work P�bd cr sub�nit anotl�a► RB Uat i�ludes /11e i�s� �aa �� tr�oow�plMed xpk yqP�on feas dv eat carty o+ror �� A� c�w9e of X10 wil be sddod for aN d� chedca. � he�el� ad�fp tl�at i inepeded 1he elec6icat i�/�ipn hereii on tl�e da�es �ee.t ROUgh - In Inspec�ipn(gj - - � Tlds m�itl ean bf n�M awYe6ls ��}� P� Braifa or on a fape. Ta �quest, 1'�D f8611297rt198. REI 02 (6/p7� or