P - 77620REQUEST FOR ELECTRIC INSPECTION
1��� 1- 6 0 9❑8 Minnesota Board of ElecUicity ��Q� - ��o?�%
1821 University Avenue Suite S-128, Sairrt Pa�, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electriciry.state.mn.us
NEW O REMODEL 0 ADDITION ❑ REPAIR Describe -using the of the ite copy'rf necessary - the woric covered by this request:
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CENFRAL FEES Outdoor Liahtina Staridard � Et
ALARM, COMMUNICATION, REMOTE CONTROL
CIRCUITS. GRCUITS OF LESS THAN 50 VOLTS
iIFAMILY DWELLINGS (PEI
3 to 12 Units � 350 Per Unit
Each Additional Unit @ S25
Rehofit
Boom
IIII IIIII �III �Ill:u��� IIIII IIIII IIII) �� I�
172"7609?
Transformers
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes ihe Service andlw Power Supply up to 500 Amperes, All
Circuits and Two Inspectioo Trips Each Dwelling Unit � f80
Reins tion Fee S20
TOTALFEE A `,
(minimum total fee is $20) `� � � � G1
T1p5 MEA FOR IIISPECTpi l6E QlY
I hereby cabfy that I impecbd Ihe ekrkical i�stalla0on desaibed herein on Ihe da�es sfa6ed:
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Request Dele: Rough♦n Inspedion Requirod? ❑ Yes }� No Irepeclan OU�er Than RougMn: �R�dy Now � WiN Call
7���� O� You must cell the ins ,
peclor when ready! Dale Reedy. .
I cerMy that I am 1he � UCENSED CONTRACTOR ❑ COIuPANY ❑ OYVNER and hereby request inspection of the electrical work at:
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Sedion Taxruhip Range Fire No. CouMy
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