P - 78098REQUEST FOR ELECTRICAL INSPECTION
1— 5 7 4- 2 0 2� Minnesota Board of Electriaiy
_ 1821 University Avenue Suite S-128, SaiM Paul, Minnesota 55104
, (651) 642-0800 T'fY/MRS 1-800�27-3529 www.electriciry.state.mn.us
❑ NEW ❑ REMODEL ❑ ADDITION PAIR Describe -using the back of the white copy if necessary - the work covered by this request:
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S RVICES I POWER SUPPLIES
0 to 400 Am ere S25
40t to 800 Am ere E50
Above 800 Am ere $75
CIRCUITS I FEEDERS
0 to 2(!0 Ampere na. $5
Above 200 Ampere @$10
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device w Apparatus @$.50
ADDITIONS TO THE �ENERAL F
MULTIFAMILY DWELLINGS (PER UNIT)
3 to 12 Units � E50 Per Unit
Each Additional Unit @ $25
OTHER ADDITIONAL FEES
Li� htin Retrofit E.25 er Fixture
Center Pivot Irri ation Boom S4(I
Manufactured Home Park Lots E25
Recreational Vehicle Park Sites ES
arate Bondin Ins Gon $20
S ial Ins on S30 er Hour
S iallns tion 5.31 Mile
THIS INSTALLATION MAY BE ORD
� Transfortners up to 10 KVA �$10
� Transformers over 10 KVA @$ 20
Transfortner I Power SuoD�Y for Sipns I OuUine Liqh6nq $5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service �dlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$BO
Fee
( TOTAL FE j I �D�S�
minimum total fee is $20
THIS MFJ� FOR N/SPECTpi USE OI�LY
I hereby cer6fy tl� I inspected the elecbical instaka6pn described herein on the dafes stated:
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