P - 79279t REQUEST FOR ELECTRICAL INSPECTION
�� 1��-- 5 2 7� Minnesota Board of Electricity -
1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 TlY/MRS 1-800-627-3529 www.electricity.state.mn.us
� NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Describe -using ihe back of the white copy if necessary - the work covered by this request:
XGEL ENERGY S�4VER"5 S'tMT�'H
GENERAL FEES Outdoor Li htin Standard $1
SERVICES / POWER SUPPLIES Traffic Si nal Standard $5
0 to 400 Am re $25 Su lemental Fee $20
401 to 800 Amoere (a) $50 Transformers uo to 10 KVA Cal $10
� 7ransformer I Power Supply for Signs I Outline Lighting @$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Darelfing Unit @$80
CIRCUITS, CIRCUITS OFLESS THAN 50 VOLTS Addilional Ins Gon Tri $20
Each S stem Device or A aratus $.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reins tion Fee $20
MULTIFAMILY DWELLINGS PER UNIT TOTAL FEE
3 to 12 Units @$50 Per Unit (minimUm total fee is $20) $20.50
EdCh Additio(121 Ut1it @$25 rHis naen Foa iravecroa use anr
I hereby certify that I inspec0ed the elecbic� installa6on described herein on ttie daBes stated:
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I Request Date: Rough-in Inspection Required? ❑ Yes aMo Inspedion Other Than Rough-In: LJRbady Naw LJ Will Call I
L��(] j� Ya must call the inspector when ready! Date Ready: �
I certify that I am the C�j�ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby r�equest inspection of the electrical work at: