P - 77340REQUEST FOR ELECTRICAL INSPECT ON ''
1���g 1� 3 7 2 6 Minnesota Board of Electricity �Q�-d��}S� �r- .�
❑ 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 = -
(651) 642-0800 TTYIMRS 1-800-627-3529 nwx�.electricity.s�ate.mn.us
Describe -using the back of the white copy if necessary - the work covered by this re uest:
EXCEL EhIERG'r' SA►!�R ' S SW I TCH
GENERAL FEES Outdoor Liphtinq Standard (�a $1
0 to 400 Ar
A01 to 800
Above 800
;UITS I FEE
Above 200 Amoere al�$10
�ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALWG
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
ADDITIONS TO THE GENERAL FEES
FAMILY DWELLINGS (PER UNIT)
to 12 Units @$50 Per Unit
Transformers u to 10 KVA $10
Transformers over 10 KVA @$ 20
Transformer / Power Supply for Signs I Outline Lighting @$5
ONE 8 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
TOTAL FEE �1 �—
total fee is $20) oc� �
OTHER ADDITIONAL FEES
Lighti Retrofit @$.25 per Fixture I hereby certify that I inspected the electrical installation descnbed herein on the dates stated:
Center Pivot Irri ation Boom @$40 ftG°0H �" oaTe
Manufactured Home Park Lots $25
Recreational Vehicle Park Sites $5 �wa� �NSPec.�ov ; onrE
$e arate Bondin Ins ction $20 -^-�� �� ^ P�
Sp2ci81 InSpBCtiO� $30 pef HOUr exPiaEO nennooNeo onre
Special Inspection $.31 per Mile
IIS IPISTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12 MONTHS
II�IIINlllllllll�lll{Illl�llllllllfl!{IN IIII
_- 3�7813726
�,, u�f i(� fQ �j �I Rough-in Inspection Required? ❑Yes �] No i, Inspection Other Than Rough-In: [,�Ready Now ❑Will Call
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I You must call the inspector when ready! I Date Ready:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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Jo� t tr t A r City
! .��� ri����HC�r� �� , ���n��r
'� Tawnship I Section
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��� ��'�G�i�i��k� k�m�J I L L I A M E _
'� Electrical Utility i Electria
I XCEL EhIEF�GY I
Range
' Fire No. I County A{� ��{A
___.I _ . .----1 ----
��� Please Provide Two (2) Phone Numbers Including Area Code
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' H�l�°����LPE�GXT�'iIC COfiF`ORATION ,co�t�acto��CASC�{J
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I I�iaii ng Address (Contractor, Company or Owner Performing Installation) �
'�300 TE�;�iITQRIAL �it�AD, SAIhfT F'AUL, h1N 55114
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Author2ed Signature (Contractor or Owner Performing Installation) - Please r�u��ue i wu << niune rvumueis i
' � ��/ �, - --- -- i �65� 646-2�11 � �
, rc vr�
IMSTRl1CTIONS ON BACK OF VELLOW COPV BOARD OF ELECTRICITV COPY
i nnascer eiecmcian or
' License Number
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