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P - 78632REQUEST FOR ELECTRICAL INSPECTION 1 3 5 8 3 7 9 e 6 a Minnesota Board of Electriciry � � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 , '�� � (651) 842-0800 TTY/MRS 1-800-627-3529 .�[ www.electricity.state.mn.us /� ��o� Identity the work covered by this request: �����D'E � j"'"Sj (� •• 1_..�-- ❑ NEW '�@EMODEL ❑ ADDITION ❑ REPAIR GENERAL FEES Outdoor Li htin Standard �$1 SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5 0 to,4G0.J\m ere �$25 'Z Od Su lemental Fee �$20 401 to 800 Am ere �$50 Transformers u to 10 KVA �$10 Above 800 Am re�$75 Transformers over 10 KVA �$20 CIRCUITS / FEEDERS Transfortner / Power Su for Si ns / Outline '' �$5 0 to 200 Am re �$5 ONE 8 TWO FAMILY DWELLINGS, EACH UNIT Above 200 Am ere �$10 � Includes the Service andlor Power Supply up to 500 Amperes, All ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwellin Unit �$SO CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ection Tri s�$20 Each em Device or A ratus �$.50 Investi ative Fee ADDITIONS TO THE GENERAL FEES Reins ection Fee �$20 _ 3 to 12 Unfts �$50 Per Unit Each Additional Unit � $25 OTHER ADDITIO� Lighting Retrofd � $25 per Falure CeMer Pivot Irtigation Boom � $4( Nianufactured Home Park Lots � $ Recreational Vehicle Park Sites � Hour ��� � I herebY ceAify that I inspected U�e THIS INSTALLATION MAY BE oRDErteo o�sccmne� � i FOR OFFICE USE ONLY f �ii��� 1���� �i�;� ��t�� �i�ii »r�� ����i ��i�� i�i� ��i� �E 1 3 5 8 8 7 9 4�E IF NOT COMPLE' total fee is desaibed Q I certity that I am the'�ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at EB-0OOOtA-13 7/1/2000 ovwnu �r c�c..�rno... w�. ..--...--"-"- -'