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Itlentify the work covered by this request:
❑ NEW � REMODEL ❑ ADDITiON ❑ REPAIR
401 to 800 Ampere � $50
Above 800 Ampere � $75
�UITS / FEEDERS
0 to 200 Ampere � $5
Above 200 Ampere � $10
RM, COMMUNICATION, REMOTE CONTROL,
�UITS, CIRCUITS QF LESS THAN 50 VOLTS
I MULTIFAMILY DWELLINGS
Center Pivot Irtigation Boom d$
Manufactured Home Park Lots �
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REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity �
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 l'TY/MRS 1-800-627-3529
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www. el ectricaty. state. mn. us
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Outdoor Li htin Standard � $1
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transtormers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su for Si ns / Outline Li hti �$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Inciudes the Service andlor Power Supply up to 500 Amperes, All
iGNALING Circuits and Two Inspection Tri s Each Dwellin Untt �$80
Additional {ns ction Trips � $20
Investi tive Fee
_S Reinsoection Fee � $20
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I certify that I am the
E&00001A-13 7/1/2000
inimum total fee is
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installadon �scribed herein on
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CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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INSTRUC710NS ON BACK OF YELLOW COPY