P - 79296, REQUEST FOR ELECTRICAL INSPECTION
❑ -. .
�����- 5 51 5 Minnesota Board of Electricity ; ;
1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
` (651) 642-0800 TTYfMRS 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 E�VERGY SAVER'S SW!TCH
GENERAL fEES Outdoor Li htin Standard $t
SERVICE51 POWER SUPPLIES 7raffic Siqnal Standard (� $5
I ALARM, COMMUNICATION, REMOTE CONTROL, SIGNAIING
� CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
�T Each Svstem Device or Aooaratus C�n $.50
3 to 12 Units @$50 Per Unit
Each Additional Unit @ $25
ONE & TWO FAMILY DWELlINGS, EACH UNIT
Inoludes ihe Service andlor Power Supply up to 5Q0 Amperes, All
Grcuits and Two Inspection Trips Each Dweiling Unit @$80
Additional Inspecfion Trips � $20
Investi4ative Fee
(minimum total fee is $20) , $i0,50
TNIS MEA FIXi INSPECi0f1 USE OI�lY
I hereby certi(y Mat I inspected the ekctrical installa6on Oescribed herein on tl�e da�s staled:
Z '�
s tion $.31 r Mile
ALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12 MONTHS
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177�551�5
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Rough-in Inspection Required? O Yes Inspection Other Than RougMn: dy Now O Y1�II Call
� D9f 20t04 I You must call the inspector whfln ready!
I czrtify that I am the [�..ICENSED CONTRACTOR �7
Job 3ite Address (Strflet Box, a Route No.) itg
616i TRfNITY DR NE
Date Ready:
OYVNER and hereby request inspection of the electrical rrork at::
Z�p Code
Fi7iDLEY 55432
l�1PlGBE4L Pl�,NCY R ( �
rrer Supplier Power Suppliar Address
XGEL ENERGY
iVactor / Company Name ConUactor License Num
HUNT ELEC7RIC CORP4RAT10N �A 008$3
iling Address (ConVactOr, Company or Owner Perfortning Insfallation)
23QIl TERRITORIAL R�,4D , SAINT PAUL, MN 55114
hurized Signature (CoMrador. Company or Own� Perfortning Installatlon)
� INSTRUCTIONB ON BACK OF YELLOW COPY BDARD OF ELECTRICT' COPY
ANOtCA
�1
�
naaster t�ecmcian or
License Number
651 646-2911 �
EB-0OOO1M74 8.1.2002