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P - 82035REQUESi FOR ELECTRICAL INSPECTION (1Q Minnesota Board of Electricity � 1� V V�- Z 7 2 �°�e 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 . (651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us � " ' Identity the work covered by this request: ❑NEW REMODEL ❑ADDITION ❑REPAIR � d' �V/� �C(J /��~ �� GENERAL FEES Outdoor Li htin Standard �$1 SERVICES / POWER SUPPLIES Traffic Sianal Standard �$5 Above 800 Am ere (� $75 � CIRCUITS ( FEEDERS 0 to 200 Am ere �$5 Above 200 Am re � $70 ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Each S stem Device or A ratus �$.50 AODITIONS TO THE GENERAL FEES Retrofit � $25 uer Flxture nspection � $2( � $30 oer Hour Transformers over 10 KVA � $20 Transformer i Power Supply for Signs 1 Outline Lighting �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT Includes the Service and�or Powei Supply up to 500 Amperes, All Circuits and Two Inspection Trips Each Dwelling Unft �$8( fee � total fee is I insoected the electrical installafian des�xibed herein on the da�s FOR OFFICE U8E ONLY f ������ ����� ����� i��t� ���I� �i��1'[ill ��I�� �1�� ��1� � "l'(� �O �E 1 O 8 6 7 7 Z 9* �'�� L�E�7�■ 18 I certity d�at 1 am the,�[ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the eiectrical work at: EB��W001A-13 7/i/2000 . BOARD OF EtECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOYi1 COPY