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P - 75379
0 flA�"rinesota De 443 Lafayette St Paul, MN ;. Phone: (65'� 0 3nt of Labor and indu�y Notth ) 297-4988 Contr�ctor Re uest for Electric� � Ro�h-fn Inspectlon Required� �! �� Conb'ador �t ucchedule Aq R Address of Inspection — Shseet �� L�% _ � �l_ f .,.0 li � vwnnr � rsrcspnvnn rvumaar�s� — m� �� � °� / fJ � "� CoMrador Alame .��v�✓�-�� Conhac�or Telaphone 1Vumber ��C� ?.S�'/ --/ 7 / — One Yes r Structure Ready Now %�io.G�G� • ��,� /��,� ��/��si� D�J� Addresa • � ���� P- ��a � � �t�J �, ►ddt�s Electric�l . i�:���+�i� -- I L`"�v r� <,� i q Fee Calculation . New Home or Assflc� 8tructure Exisiing Hame/Structur� Remadel or Additlon P►�a DwelWtg SeroloeJPo�rer Suppty 0- 400 ampere (� $35 Na�v Servtce/Povuer SupPly 0- 400 emPere @$35 Ne�ro Dmretling Servi�/Pow+er Suppiy 401- 8� ampere (QD $80 Pte�a Servic�/Pawer 3uppiy 401- Sa0 ampere (�i $BO IVetlll DmteIINtS� F8�8/CiiCU1t8 Al�or Feed�rRft`.��tta _ 1 in ►n �s F�we.,�rr_�..,r.e 0 0 Detached Garage or Other Assaclatec# 3truc�r� Ne�n► SeNk�lPonrer Supply o- 40o ampera �$3s Plew Feeders/Circ�lts ( ) � $8 Eac� 0 Detached (�arage or Other Assodat�i Strvcture New Servt�/Power BuPPh► 0- 400 empere (� S35 i�v Feed�ts/Ct�tte ( ) � $B Esdt Rec�ennested �'�dera/Circuits ( ) C� $2 Ea� . . � l'l ,� � � Tataf (tlre f� c�lada�d abowa or �i5 multipli� Total (the fee celr.ulated ab�re w$35 mult�pfied - —���f tsalui�MsA�taRtrips. - - — - bythenttmber-ofrequ t�ps; ---- - whidtever is greatar) whicheve► fs greater) ��j� � Reques� for Etettrtaal I�� �� e f� � 5�80 or l� expira 12 mo�hs from tf�s �Iing �te. Ths �r muet l�ve ihe termk �mpJ�d avtthin tl�e 12 mtmth pariod w submtt anatl�er 1�1 �at tncludea tda t�on tee tar the uncomplet�! wo�ic. ��Ctton te� do � carrq ov� from are REl to enotiter. A servics cherge of S30 vrUl � ad8ed br eU d�hcrtorad checks. �� e�y tF�t � h�a the �e�iral �n r►erein � the � s�: For �paranene use anly Raugh - In Inspec�on(s) Date rh�s nremr�e� can � TDD (889) 287-4198. RE102 (8lO7j --�. Z�����C� � �/ �?� �' � REC'D N 0 V 13 2008 such ae tar� pd s or on a tepe. To reaueat. aa111-800�42.8 �, or