P - 79272❑ REQUEST FOR ELECTRICAL INSPECTION
�� 1.� �- 516 p Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTYlMRS 1-80�-627-3529 www.electric�ty.state.mn.us
fl NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
7lCEL ENERGY SAVER'S SWITCH
GENERAL FEES Outdoor Liqhting Standard na. $1
SERVICES / POWER SUPPLIES
0 to 400 Amcere C� $25
Above 800 Am ere $75 Transformers over 10 KVA $ 20
CIRCUITS / FEEDERS Transfortner / Power Su I for Si ns I Outline Li htin $5
0 to 200 Am e $5 ONE 8 TWO FAMiLY DWELLINGS, EACH UNIT
Above 200 Am re $10 Includes the Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMl1NICATION, REMOTE COtSTROL, SIGNALING Circuits and Two Inspection Trips Each Daelli� Unit @$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Addilional Ins tion Tri $20
Each S stem Device or A araius $.50 Investi ative Fee
ADDITIONS TO THE GENER4L FEES Reins tion Fee $20
MULTIFAMiLY DWELLINGS PER UNIT TOTAL FEE
3 to 12 Units @$50 Per Unit (minimum tota� fee is $20) $2�.5�
EeCh Additi0nel Unl[ @ $25 rwsa�aFOarcsrECroauseaar
I hereby certiy that I inspected the elecbical installation described h�rein on tlie dates stated:
Center Pivot Irriqation Boom
Hour
l�ll II Ilf � Iii {{ I� II I II H�I INH N�I h III I IIH
17735],[�8
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: R. � 271
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Request uate: Rough-in Inspection Required? U Yes L_YNo I�spad'+on Other Than RaugMn: L3Ready Novr LJ Will Call
�gJ��(� You must call the inspector when ready! Date Ready.
I certi(y lhat I am the C�.ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecdon of the electrical work at:
INSTRUCTIONS ON BACK OF YELLOW COPY BOARD OF ELECTRIGTY COPY EB-0OD01M11 8.1. 2002 �