P - 81998REQUEST FOR ELECTRICAL INSPECTION
�� Minnesota Board of Electricity �'�
1� 13 7- 7 7 4� �821 Universiry Avenue Suite S-128, Saint Paul, Minnesota 55104
� TM� (651) 642-0800 TTY/MRS 1-800-627-3529
, www.electriciry.state.mn.us 't '
Identity the work covered by this request: 0�
❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR � "
GENERAL FEES Outdoor Li htin Standard �$t
SERVICES / POWER SUPPLIES Traffic Si nai Standard �$5
0 to 400 Am ere �$25 Su lemental Fee C� $20
401 to 800 Am re�$50 Transformers up to 10 KVA C� $10
Abwe 800 Am ere @ $75
CIRCUITS I FEEDERS
0 to 200 Am re �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or aratus �$.50
ADDITfONS TO THE GENERAL F
MULTIFAMILY DWEILINGS (PER UNITI
Center Pivot irrigation Boom � $
Manufactured Home Park Lots 8
� $.31 cer Mile
Transformers over 10 KVA � $20
Transtormer / Power Su I tor Si ns I Outline Li htin �$5
ONE & TWO FAMILY DWELLIfdGS, EACH UNIT
includes the Service and/o� Power Supply up to 500 Amperes, All
Circuits and Two Ins ction Trips Each Dwellin Unit �$SC
Additional Inspection 7rips � $20
� Investiaative Fee
I herebvi cerli(v U�at I
total fee is
FOR OFFICE USE ONLY
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Requ Date: Rough-in laspection Required? ❑ Yes o Inspection Other Than Rough-In: ady Now wII Call
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You must call the inspector when readyl Date Ready:
I certity that I am the �CENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the elechical wo�C at:
Job Address (Street, Box, or oute No.1 Ciry <'� � 7ap Cafe _ n�
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S ion Township Range Fire No. Counry
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EB-00001A•13 7!1l2000
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, any or er Pertortning Installation)
BOAqD OF ELECTHICfTY COPY
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INSTqUCTIONS ON BACK OF YELLOW COPY