P - 79336' REQUEST FOR ELECTRICAL INSPECTION
Jz ����- 6 0 4 20 Minnesota Board of Electricity �
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
` (651) 642-0800 TfY/MRS 1-800-627-3529 www.electricity.state.mn.us
NEW ❑ REMODEI ❑ ADDITION Q REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
XCEL ENERGY SAVER'S SWITCH
GENERAL FEES Outdoor Li hting S:andard @$1
RVICES 1 POWER SUPPLIES Traffic Sianal Standard t�a $5
0 to 400
AtARM, COMMUNICATION, REMOTE CONTROI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Center Pivot Irrigation Boom �a
Manufactured Home Park LoGs
�(� �� II I� II I� (I III I��I� II �I I{ I� �� � I IIII
177�6042
Transformers u to 10 KVA S10
Transformers over 10 KVA $ 20
Transformer I Power Supply for Siqns I Outline Liphtinq �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes lhe Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$80
(minimum total fee is $20) � $2U.50
iH15 MEA Fdi IIEPECTpi USE ONLv
I hereby certify Mat I inspecled �e elechic� installation deuribed herein on the dates staled:
a- b° �F'L oi $l/
Gf<ha�/
,�5a � l
� S�
Reques� uace: Rwrgh-in Inspection Required? ❑ Yes O�Ro Inspectian Other Than Rough-In: ❑ dy Now ❑ Wdl Call
�9i��%Qti You must caA the inspector when ready! Date Ready:
I certify that I am the �)CICENSED C�ITRACTOR � COMPANY ❑ OWNER and her�by request inspecfion of the electrical work at:
.�o �...... �...na vn ow�,n �r icuimr cppr BppRp OF ELECTRICT' CAPV EB-0OOO1M14 8:1. 20D2