P - 77682REQUEST FOR ELECTRIC L INSPECTION �a�'f ""'
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Q Minnesota Board of Electricit �� � y� �
1� 8'J$ � 6$ 2 � 1821 University Avenue Suite 5-128, ain Paul,�inne��5104 �. "�
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us ���
Describe -using the back of the white wpy if necessa - the work covered by tbj�quest:
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GENERAL FE Outdoor Lighting Standard $1
SERVICES / POWER SUPPUES Traffic Signal Standard @$5 �-
` Above 200 Am ere $10
ALARM, COMMUNICATION, REMOTE CANTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus $.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNIT
3 to 12 Units @$50 Per Unit
Each Addifional Unit @ $25
OTHER ADDITIONAL FEES
Lighting Retrofit @ $.25 per Fixture
Center Pivot Irriaation Boom (� $40
Supplemental Fee @ $20
Transformers u to 10 KVA $10
Transformers over 10 KVA $ 20
Transformer I Power Su I for Si ns I Outline Li htin $5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dweliing Unit @$80
Additional Inspection Trips @ $20
Investigative Fee
Beinspection Fee (�a $20
fee is $20)
I hereby certify that I inspected the electrical installation descnbed herein on the dates stated: �
Manufactured Home Park Lots $25 .
Recreational Vehicle Park Sites $5 F��uNSPec.�oN oq,�
Se arate Bondin Ins ction $20
SpBCi81 If1SpECtiOn $30 pC� HOUf Exaiaeoinenr�oor+EO oaTE
Special Inspection $.31 per Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED_IF NOT COMPLETED WITHIN 12 MONTHS __ _
I IlII II III II III II III II III II (II II III II III N� I�I
L8986828
Rough-in Inspection Required?�ES--$1io Inspection Other Than Rough-In: ❑ Ready N Wi�l Call
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You must cail the inspector when ready! Date Ready:
VSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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Utility I Electncal UtilRy Adc
l
r / Company Name
WEBER ELrCTRIC. I(dC.
idr_ C__ _ __ ^^r__, inglnstallatlon)
Please Provide Two (2) Phone Numbers Including Area
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�qbc�y Master Electrician or Power Limited 1
r� License Number
` PHONE: (651) 490-1333
� Provide Two (2) C o e�mb1 Inclul4�
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� EB-00007A-15