P - 80182, REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
� 1-396-153 � 1821 Universiry Avenue Suite S-128, Saint Paul, Minnesota 55104 -
(651) 642-0800 T7Y/MRS 1-800-627-3529
www. electricity.state.mn. us
Identify the work covered by this request:
LlryEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
Above 800
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
Center
I Home Park Lots �
VehiGe Park Sites �
XCEL ENERQY SAVER'S SWITCH
to
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service anNor Power Supply up to 500 Amperes, All
Circuits and Two Inspecdon Trips Each Dwelling Unit �$80
Additional Inspection Trips � $20
I hereby cerM1ty M
ROUGHIN
FIW1L INSPECTION
FEE
tlescribeC Irerein on the dates steted:
UATE
— _ —.— _ _ _ _ _ � _ � _ � _ _ � _ _ � _ _ � _ � _ _ � _ � _ _ � _ _ _
FOR OFFICE USE ONLY
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Reque���2 Rough-in Inspection Required? ❑ Yes �No Inspection Other Than Rough-in: �Ready Now ❑ Wfll Call
You must call the inspector when ready! Date Ready: �
I certity that I am the �4 LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby rgquest inspection of the electrical work at:
Job Address1�� Bo� g,��'� �� �� FRiDL.EY zp �e �3Z
/ LAK
Section Township Range Fire No. County aNaca
Occupant Phone
KRACK JOHN LESLIE
Power Supplier Address
%CE� ENE�Y
Electrical Contractor / Company Name Contractor License Number Master License Number
HUNT ELEGTRIC 04RPORATION CA 00883
Mailing Ad� Contractor,�Company o�r o� ��AIM1iT�PAUL�MN 55114
Al
Authorized �Sig nature (Contractor, Company or Owner Perfortning Installatlon) Ptrone
�'.,�rM�els �� 651 6�2911
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY