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P - 77378REQUEST FOR ELECTRIC L INSPECaTION 1�� O�= 3 5 3 6 Minnesota Board of Electricity G�� �^ ��U %� ''�e�� ' �r 1821 University Avenue Suite S-128, Saint Paul, Minnesota 5104 �. , (651) 642-0800 TTY/MRS 1-800-627-3529 wtivw.electriciry.stule.mn.us Desaibe -using the back of the white copy if necessary - the work covered by this request: EXCEL EN�'RGY SAUFF� "S SWITCH GENERAL FEES Outdoor Lighting Standard @$1 SERVICES / POWER SUPPLIES Traffic Signal Standard @$5 0 to 400 Ampere $25 Supplemental Fee $20 401 to 800 Am ere $50 Transformers u to 10 KVA $10 Above 800 Am ere $75 Transformers over 10 KVA $ 20 CIRCUITS I FEEDERS Transformer / Power Su I for Si ns I Outline Li htin $5 0 to 200 Am re $5 ONE & TWO FAMILY DWELLINGS, EACH UNIT Above 200 Am ere $10 Includes the Service and/or Power Supply up to 500 Amperes, All ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelling Unit @$80 CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ection Tri s $20 Each Svstem Device or Aooaratus la� $.50 Irnestioative Fee 3 to 12 Units @$50 Per Unit Each Additional Unit Q $25 OTHER ADDITIONAL FEES Liahtina Retrofit na $.25 oer Fixture w �vi'+�rc� .� total fee is $20) �' ��'"4'r,°� that I insoected ihe elecirical installation described herein on ihe dates stated: �--�- - - Z - 2F%s � � S cial Inspection $30 per Hour `""'"`° """"°""`° °"" Special Inspection @ $.31 per Mile TNIS 1NSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12 MONTHS IIII � III II I� II I� II I� II III II �I H III II III I!I�I 178L3'S36 �'�, U�lL(}�� �j 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: -----------------_ �r�'��r���t���`��F`iLITE BLVI} icav��ID�EY ��, Township ;°'�'��E°�`��'g�aus sau�o Section I Range I, Fire No. � County �{� p KA —._�.. —. .. �. � ��Please Provide Two (2) Phone Numbers Including Area �( ) ( ) I Electrical Utility ', Electrical Utility Address XGEL EhlERGY �— — -- — ��pqkyFt�/G�rnqar}y-0IameG �p��,���.�i�� Contractorl,icanse,(Jyirpbp{� MasterElectricianorPowerLimitedTechni I t'IUIY cLGI, i hJ. l�t-1 t�lttf[3 �LicenseNumber � i � — — — — — — — — — — — — — — — — -- — _ . — . . — — ---� —_-------- I Mailing Address (Contractor, Company or Owner Performing Installation) � �'�d0 TE�,F;ITORIAL fi0a�i, S�4IhIT F'AUL, �Ihl 55119 —_ _ _---___------------- AuthorizQd Si � na�ntractor or Owner Performing Installation) II PIEa,S�Proyicl� jwq,�7„1 ihpne � mbers Including Area Code —� - --- -- i a'� b 4 fY �f t j