P - 79288REQUEST FOR ELECTRICAL INSPECTION
,� ����- 5 3 7 0 Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
P� NEW O REMODEL O ADDITION ❑ REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
KCEL ENERGY SAVER'S SWlTCH
GENERAL �EES Outdoor Liphling Standard (� $1
0 to 400
Standard
Fee (� $
0 to 200 Am re $5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re $10 Includes the Service andlor 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 tion Tri s $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 @$59 Per Unit {minimum tota� fee is $20) $24.50
EaCh Addltlonal Ullit @$25 Tws na� va+u�cTOa use orar
I hereby certify that I inspected ihe electrical installa�n desrxibed I�erein on the dates sta0ed:
Pivot Irriaation Boom
0
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT GOMPLETtD WI I MIN l"l MUn 1 Fi�
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Request Date: Rough-in Inspection Required? ❑ Yes Inspedion Other Than Rough-In: ❑ ady Now � WNI Ca�l
� �9 f20(� You must call the inspector when ready! Date Ready:
I certify that I am the C�ICENSED CONTRACTOR ❑COMPANY � OWNER and hereby request inspection of the electrical work ax:
INSTRUG710N6 ON BACK OF YELLOW COPY BOARD OF ELECTRICITV CAPV . ce-uuunr-�a o.�. �w�