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 (� ••
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❑ 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
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I herebY ceAify that I inspected U�e
THIS INSTALLATION MAY BE oRDErteo o�sccmne� � i
FOR OFFICE USE ONLY
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IF NOT COMPLE'
total fee is
desaibed
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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�. ..--...--"-"- -'