P - 75638Minnesota De
443 Lafayette
St. Paul, MN
Phone: (65�
TTY/MRS:
www.ele at
Date
5/21 /08
�r�iient of Labor and Industry
�ad North
�155-4342 � •
34-5064
) 297-4198
state.mn.us
�r Re uest for Electrical
Rough-In Inspection Required?
/1UUIC.7:i UI 111?3�.JCGUVII - JU�
7360 LYRIC LANE NE
Owner Name
LARRY NIERENGARTEN
Owner Telephone Number(s) - Include Area
Yes
2317
I IIIIII IIII IIIII IIIII IIIII IIII IIII
— One Famil Dwellin /Associ
Single Inspection Other Than Rough-In:
Contrador Must Schedule All Final Ins
Cit�rlfownship County
FRIDLEY ANOKA
Structure
] Ready Now
1 wn s�r,eduie
UPGRADE SERVICES FUSES TO BREAKERS
JOB #80521010
(TONY CZECH)
Contractor Name Contractor Mailing Address
ELECTRIC RESOURCE CONTR 4024 WASHINGTON AVE NORTH, MINNEAPOLIS, MN 55412
12) �-6511
rce.com
CA 00585
Fee Calculation
New Home or Associated Structure
New Dwelling Servir,e/Power Supply 0– 400 ampere @$35
New Dwelling Servic;e/Power Supply 401 – 800 ampere @$60
New Dwelling Feeders/Circuits
Up to 30 Feeders/Cin
New Home – More than 30 Feeders✓Circuits (in addit
above) ( ) Feeders/Circuits Up To 200 A@ s
Other (Specify)
KCEL ENERGY
Job/Projed ContacF eF-rson ---
TONY CZECH 612-221-3004
Existing Home/Structure Remodel orAddition
Idew Service/Power Supply 0– 400 ampere @$35 $35
New Service/Power Supply 401 – 800 ampere �$60
Newr/Extended Feeders/Circuits – Up to 15 Feeders/Circuits
a - $100 Feeders/Circuits $
to New/Extended Feeders/Circuits –
Detached Garaqe or Other Associated Structure
New Service/Power Supply 0– 400 ampere @$35
New Feeders/Circuiis
Other (Specifir)
( ) � $6 Each
A CaD $6 Each
( � 4 ) Feeders/Circuits @$2 Each ��
Detached Garage or Other Associated Structure �
New Service/Power Suppty 0– 400 ampere �$35
New/Extended Feeders/Circuits ( ) @ $6 Each
Reconneded Feeders/Circuits ( ) � $2 Each
Other (Specify)
TOtal (the fee plculated above or $35 multiplied TOhdl (the fee plculated above or $35 multiplied
by the number of required inspedion trips, by the number of required inspection trips, �3
whichever is greater) whic�ever is greater)
Requ�ts for Electrical Inspectlon (REq wfth a fee of $250 or less expire 72 months from thq fllirtg date. The cor�tractor must have the work complet� wlthin
the 12 month period or submlt another REI that includ� the InspecUon fee for the uncompleted work. Inspedlon fees do not carry over from one REI to
another.
A service charge of $30 will be added for il dishonored checks.
� "
I hereby certffy that 1 inspeded the electrical installation herein on the dates stated: For Deperbnent Use Only ��'�
Rough - In Inspection(s) D�te (J
Final Inspection Date , `�_ � ��� � <� � �
i /? �' . . 7' _n����
Th� materral can be made avaHable In dif(eren�
TDD (6b'1 j3�T�19S — — -
REI 02 (6/0�
-� yi'��� �
r�, such as large print, Bralll� or
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