P - 82428REQUEST FOR ELEC7RICAL INSPECTION
� m Minnesota Board of Electriciry �`"�
1- 0 2 4� L O O �'w � �82� University Avenue Suite S-128, Saint Paul, Minnesota 55104
�` aP��;�� (657) 642-0800 TTY/MRS 1-800-627-3529
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www. electrtci ry. state. mn. us
IdentiTy the work covered by this request:
❑NEW ❑REMODEL ❑ADDITION EPAIR �CL,(„Jr11�j(�i� ���%�Q��
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Amoere �$25 Su lemental Fee �$20
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus f� $.50
ADDITIONS TO THE GENERAL F
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units (� $50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
n Boom � $4
Park Lots �
Park Sftes �
Transformers u to 10 KVA (� $10
Transformers over 10 KVA � $20
Transiormer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$80
Additional Insoection Trios � $20
ipecial Inspection �$.31 per Mile I I L.
THIS INSTALLATION MAY BE ORDERED DISCOMNECTED I
Fee �
I inscected the eledrical
total fee is
on tl�e dates stated:
���
1 cerbfy that I am the j�110ENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: