P - 75497Minnesoea Departrner�t of Lahor and Industry
443 Lafeyette RQ�d Nortl�
St Pau1, MN 5,�� 55.4342
Phone: {651).��4.5pgq
TfY/MRS: �1j 297-4198
Date
-�—G�
Addr�ss
Rough-In Inspec�iCn Ftequfred�
0
� y� �� ����
�uame
�� Qv �,,/`-�
�e one Number(sj — include ,Area C�
— C��.S��'
tor/Registered Empbyer Name
5 p
�' �` :.�
tarlEmplayer Tet�h ,ne Number
- �.IG-i9�?�sr1 �.�.�-i����
for
Ye&
cr* r- �'r�� �I e. "'
� ���d �n r� a � L 1��,� �Q
�
�x�� c ����-� , �
�l ��
�;�CG�.-� � � �0�����G --- - .--- _-
r � - _____
�ee Calculation
Seroice/Poaver SupP�Y 0— 40Q arttpere (� $35 Tedlnology Sysbem Devlce9 (
Senrice/Power SuRph' 401— 800 ampere �$60 ��� Banding Inspectians for Swinur
rttlal Ptaees
Sen+(c�IPower SuPP�Y Above 800 am�re [� $100 ��r Pivot inlgatfon Boams (
Plus Ele�rical Ddve '
FeederelCircuits Up To 200 A {�i )�$6 EaCh � Lurninafre Retrofit Modifleatior�s (
Feede�s/Circuuits Atrove 200 A ( i�$15 Each Concrate-Encesed Electrode InsReCtion (
G�econnected FeederslCircuits ( j�$2 � ��g� �ee $70 Or The Toial.lnspei
Whichever Is Grea�er U To $1 Qa0
Manufactured Home Park Lot Supply ( }�$35 Each Spedal Ins�o�ctt�on Fee { ) H��
bn...e�ti......� v.,Vt�6. c�u� �..�_.__ �_ .._ .
�8 �Ml(es � The IR5 Mit�
Street, Pa�cing Lot, Lightfnp Standerd { )� gg ��
Transforrners Up to 10 kva � ( )��16 Each
) � 75¢ Each
g Pools and
) c� as¢ Eac►�
) � $35 Eac�t
Hour
aver B�0 Votts — r�caa n� eomn�a �r�, �+p�N �,a reeaenara��t� ro
raa�s m aeutr� nre reg�arrea (d�ae na�+N � e� mgn ena au1Me eQhen�
( } New Multi-FemlfY �afellfnoc � ��n e�..�.
Ready Now
wu scr,�d�
� �r�(C�
❑�
. UV�t� Up To ZO Feeder�/Circui�
Trar�sformers Over 10 kva ( )� g34 Each � Eec �d�ionaJ Giraifts Above The 20 AUow►ed Per Unit
Electetc Sfgns and Outline Ughtlng Tt9tSl (the Pee alculatesi abavs or �� �tiP�B� ��
TranslormsrsiPower Su Ges $3 Each by the number af re9utred inspectlon % S4
whichever Is 9teater} 6 �,
Requests for Electrical InsPeetfon (REIj +� � ffle of aZ60 ar less expire 12 mn� ftam�hs fWrtg date. The canbaetorle
compteted wtthln the 12 month paflod or submlt another REI that t�lud� the f��tion�e Tor the uncompiet� work. ��r must have the wak
trom ane REI to anotHe�' ��Pection te� do rwi carry over
.—. --� —.•••� .••.•. ... �.,�,�.,av� u�v e�ex:uzs� u�9IS1+�Or1 tIBT@71I Olf Th8 d8iB8 S�i
Rough — In Ir�pecdon(s) - , Date
,r�"' �_ �l5 �°
Fnel Inspection p�
id °�,s�
Thls materlat can be �rrade available In dlfterent fomis. aucF� as large I
TDD (651) 297-4t98.
REf 03 (8/07') �
REC'D AUG 1 g 2006
or on a tepe. To r�uest ,�u �a�en
or