P - 79169� REQUEST FOR ELECTRICAL INSPECTION
`� ���� 7,.. Q Z O � Minnesota Board of Electricity -
� `� 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
NEW 0 REMODEL ❑ ADDITION ❑ REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
XCEL ENERGY SAVER'8 SWlTCH
GENERALFEES
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus @$.50
ADDITIONS TO THE �ENERAL FEES
MULTIFAMILY DWELLINGS PER UNIT
3 to 12 Units �$50 Per Unit
Each Addi6onal Unit @ $25
OTHER ADDITIONAL FEES
Li hGn Retrofit $25 er Fixture
Center Pivot Irci ation Boom $40
Manufactured Home Park Lots R25
Recreational Vehicle Park Sites $5
arate Bondin Ins tion $20
S ial Ins on $30 r Hour
S ial Ins tion $.31 r Mile
THIS INSTALLATION MAY BE ORDEREC
i lili iI �I iI III Ii IN iI��I II iIi I I iH � lli il �i l i�
7,7579707
Traffic
Fee @ $20
up to 10 KVA
over 10 KVA
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes ihe Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspec6on Trips Each Dwelling Unit @$80
TOTAL FEE
(minimum total fee is $20) 20.50
THIS AREA Fpt Il6PECi0R USE OI�Lv
I hereby cer6y that I inspected the electrical instaUa6on described haein on the daffis sf�ed:
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Reques[ Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Ragh-In: QReady Nwr � Will Call
�i�1 ���i You must call the inspector when ready! Date Ready:
I certify that I am the :�l LICENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
INS7RUCTON$ ON BACK OF YELLOW COPY BOARD OF ELECTRICITV COPY EB-0OOD1A-14 8.7. 2002