P - 79334� REQUEST FOR ELECTRICAL INSPECTION
�` 7 7��� O^ � Minnesota Board of Electricity -
� 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� (651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Describe -using the back of the white copy if necessary - the work covered by this request.
XCEL ENERGY BAVER'S SWITCH
GENERAL FEES Outdoor Lighfing SSandard @$1
CIRCUITS / FEEDERS Transfortner / Paxer Su I for Si ns I Outline Li htin 35
0 to 200 Am re $5 ONE & TWO FAMfLY DWELLINGS, EACH UNIT
Above 200 Am ere $10 Includes the Service andlor Power Supply up to 5�� Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two inspection Trips Each Dwelling Unit @$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Addifional Ins tion Tri s $20
E�h Svstem Device or Anoaratus C15.50 Investiqative Fee
fIFAMILY DWELLINGS PER UNIT TOTAL FEE I
3 to 12 Units @$50 Per Unit (minimum total fee is $20) $20,50
E2Ch Addifional Unit Q$25 rws nnEn Fon insffcroa use aar
I heteby ceNry tlwt I i�spected the electrical installaAOn descnbed h�ein on the da�s sia�d:
OTHER ADDITIONAL FEES �G� �,,,_ 0 ��.� �
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Request Date: Rough-in Inspection Required? U Yes LYltlo Inspection Other Than Rwgh-In: IJR�ady Now L.I WiU Call
�Q�j�� You must call the inspector when ready! Dete Ready:
I cert'rfy that I am the �ICENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request inspection of the elecVical work at:
IN57RUCTONB ON BACK OF YELLOW COPY BOARD OF ELECTRICITV COPY . E&00001M71 8.1. 2002