P - 77342REQUEST FOR ELECTRICAL SPECTION �w�
1�� 8 1� 3 4, 8 a Minnesota Board of Electricity �.�;� 0�8 /„� �-- _
1821 University Avenue Suite S-128, aint Paul, Minnesota��5104
(651) 642-0800 TTY/MRS 1-800-627-3529 www�.electricity.slate.mn.us
Describe -using the back of the whi(e copy if necessary - the work covered by this re uest:
EXCEL ENERGY SAV�R'S S4;ITCH
GENERALFEES
CIRCUITS I FEEDERS
0 to 200 Am ece $5
Above 200 Ampere @$10
ALAF2M, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
TIONS TO THE GENERAL F
_INGS (PER UNIT)
to 12 Units @$50 Per Unit
3ch Additional Unit @ $25
OTHER ADDITIONAL FEES
ahtinq Retrofit (cil $.25 oer Fixture
Park Sites
Outdoor Liqhtinq Standard
Transformers u to t0 KVA $10
Transformers over 10 KVA @$ 20
Transformer / Power Supply for Signs / Outline Lighling @$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Inciudes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
TOTALFEE
total fee is $20) � •5b��
that I inspected the e�ectrical installation described herein on the dates stated:
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Special Inspection @$30 per Hour °"""°° """"°°"`° o"`E I
Special Inspection �a $.31 per Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12 MONTHS
I IIII II �I II i� N IN II I� II III II �i II lil li III I iill
1 7 8 1 3 4 8 6
I, ��l�q f4 5 I Rough-in Inspection Required? ❑ Yes � No I Inspection Other Than Rough-In: [�Ready Now ❑Will Call
i I You must call the inspector when ready! I Date Ready:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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J �it Str A ss _ � I City
;���? h�l�`� kDGE WAY NE � FF�IDLE'(
.'��Township I, Sec[ion i Range j Fire No. County ��� �A
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��, Owner/Occu nt Name - 1 � Please Provide Two (2) Phone Numbers Including Area Code
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�lectrical Utiliry i Electrical Utility Address
' XCEL EhIEhGY
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I���,r,/ E�p�n,y,�,� �C �0��'��A�,I�� , Contractor �cennsejJ�rr�p�j J , M�nseENucmbe�n or Power Limited Technic
l, t) tf Zi
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'�i Maling Address (Contractor, Company or Owner Performing Installation)
!�:.:�00 TE��TTORIAL R�]AD, SAINT 1-'AUL, I�hl 551i�
�—.---------_ ------_---- --- ----- —.—_—
� Authorized Signature (Contractor or Owner Performing Installation) � Please Provide Two (2 Phone Numbers Including Area Code
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INSTRUCTIONS ON BACK OF YELLOW COPV BOARD OF ELEC7RICITY COPY FR-nnoMA-15 B 1: