P - 79324' ❑ REQUEST FOR ELECTRICAL INSPECTION
1� 1 1�- 5 91 1 8121 UnrversBy Aven� eESu te S 28, Saint Paul, Minnesota 55104
� (651) 642-0800 TTY/MRS 1-800-627-3529 www.electrictty.state.mn.us
t5 NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
X,CEL ENERGY SAVER'S BVVITCH
GENERAL FEES Outdoor Li9htinq Siandard p$t
SERVICES
OtoM
CIRCUITS / FEEDERS
0 to 200 Am re $5
Above 200 Am re $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or aratus $.50
ADDITIONS TO THE GENERAL FEES
Each
Center Pivot Irripafion Boom
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1 7 7 3 5 9 7, 1
Standard
to
ONE & 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
(minimum total fee is $20) � $20.54
THIS RREA Fq21N5PECTp2 USE qLv
I hereby certify that I inspected ttie electrical instaXa6on descnbed he2in an the da�s staEed:
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Request Dete: Rpugh-in Inspecfion Required? ❑ Yes Inspection Other Than Rough-In: dy Now ❑ VYdI Call
�QJ��j�Q You must call the inspecla when ready! Date Ready:
I certify that I am the C�ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and heieby request inspection of the electriql work at:
Job Site Address (Street, Box, or Route No.) Ciry Zry Code
7410 AAELODY DF? NE FRIDLEY 55432
Section Township Range Fire No. County
Ai�:�K/Qt
Owner/Occupant Name � � Please Provide Two (2) Phone Number(s) Indudirg Area Code
BARNETT DENNIS � '� ( � ' ( ) ( �
Power Suppli� Power Suppli� Address
XCEL ENERC3Y
CoMrector / Company Name ConVactor License Number Master FJectriaan a Power Limited Technician
HUNT ELECIRIC CQRP4RATION CA 00868 u�se �x'mter
Mailing Address (Contractor, Company or Owner Pertorming InstaNation)
2300 TERRlTdRIAL ROAD , SAINT RAUL, MN 55i 14
Authoraed Signature (CoMrector, Company a Owner Perfartning Installation) Phone (s)
�(sa�ois� 661 646-2911
INSTRUCTONS ql BACK OF YELLOW COPY BOARD OF EIECTRICT' CAPV E&00001A-14 8.1. 2002