P - 75949REQUEST FOR ELECTRICAL INSPECTION `��'
� s 9 7�� 3� 2 � Minnesota Board of Electricity `
1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55fi�4 �'- �
� (651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
Descn -using tt��ck of tha white copy'rf necessary - the work covered by this requ
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GENERAL FEES utdoor Lighting Standard @$
SERVICES / POWER SUPPUES Traffir. Sienal 4Yanriard IrT �5
;UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus @$.50
ADDITIONS TO THE GENERAL FEES
orHeR
CeMer
� Transformers over 10 KVA $ 20
� Tiansformer / Power Supply for Signs / Outline Li htinq $5
ONE & NVO FAMILY DWELLINGS, EACH UNIT
Includes tha Service and/or Power Suppry up to 500 Amperes, All
Circuits and Two Inspectlon Tdps Each Dwelling Unit @$80
TOTAL F j � �� ��
inimum tatal fee is $20 B
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I Nsped� itre electrical 6�fallatlon desaibed herein on the dat� s�ted:
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s al Ir�s on $30 r Hour °��� w�� �
Special Ins 'on $.31 r Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED 1NITHIN 12 MONTHS
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( °� You must cell the inspector when readyl Date Ready: °� �
I certify tftat I am the �ICENSED COM'RACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at
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