P - 79986� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
� 1-396-173 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-OS00 TTY/MRS 1-800-627-3529
www.electricity.state.mn. us
IIdentify the work covered by this request:
O�IiIEW ❑ REMODEL ❑ ADDITION 0 REPAIR
Abwe 200 Am ere � $10
AIARM, COMMUNICATfON, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOITS
��Each Svstem Device or Moaratus � $.50
to 12 U�its �$50 Per Unit
ich Additional UnR � $25
OTHER ADDITIONAL
ghting ReuoNt � $25 per Fixture
enter Pivot Irtigation Boom � $40
anufactured Home Park Lots � $25
ecreational Vehicle Park Sites � $5
�parate Bonding Inspection � $20
�ecial Inspection � $30 aer Hour
xc�� ErvE��v
Outdoor
Transfortners overl0 KVA � $20
Transfortners / Power Supply for Signs / Outline Lightlng �
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two I�pection Trips Each Dwefling Unit �$F
Additional Inspection Trips � $20
ROUGH IN
FINAI WSI
use
linsoectetl Ihe Blectrical
TOTAL FEE I �'�I
d fee is $201
aees stated:
DATE
z— � 3
FOR OFFlCE USE ONLY
1 II��II ItIII NI� IIIII II�� I� I��II II�1 ��� ���
* 1 3961 735* � �Q�b
Requs�,� Rough-in Inspectlon Required? ❑ Yes fZNo Inspection Other Than Rough-in: L7fieady Now ❑ Will Call
JL 7�
You must call the inspector when readyt Date Ready:
I certity that I am the I� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electncal work at:
Job Addrass (Street, Box, or Route No.) City rp Code
185 RIYER EDOE WAY NE FRIC�I.EY 55#32
Section Township Range Fire No. County A�A
� r
Occupant Phone
WIF..dEI�lAN TiM M
Power Supplier Address
� �Y
Electrical Contractor / Company Name Contractor License Number Master License Number
HUNT ELECTRIG GQRP�C)RATIQN Cl� 00883
Meiling Address Contractor, Company or Owner Perfortning Installation)
2300 �TORiAL f�OAD , SAINT PAUL, MN 55114
Authorized i nature (Contractor,�� r Owner Performing InstallaTion) Phone
i4 651 �+6-2#i11
E&00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY