P - 77681REQUEST FOR ELECTRICA NSP C�jI `�T�'��'�
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1� 8 3 9�- 9 5 6� Minnesota Board of Electricit OD
1821 University Avenue Suite S-128, Sai aul, Minnesota 55104 �`����
(651) 642-0800 TTY/MRS 1-800-627-3529 wkryv.electricity.state.mn.us �,�i�
Describe -using the back of the white copy if necessary - the work covered by this request:
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GENERAL FEES Outdoor Lighting Standard $1
SERVICES I POWER SUPPLIES 7raffc Sinnal Standarrl rl A5 I
Above 800 Am ere $75
CIRCUITS / FEEDERS
0 to 200 Am ere $5
Above 200 Am ere $10
ALARM, COMMUNICATION, REMOiE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or A paratus $.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNIT
3 to 12 Units @$50 Per Unit
Each Additional Unit @ $25
OTHER ADDITIONAL FEES
Lighting Retrofit $.25 per Fi�ure
Center Pivot Im ation Boom $40
Manufactured Home Park Lots $25
Recreational Vehicie Park Sites (� $5
Supplemental Fee
Transformers up tc
Transformers over
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuik and Two Inspection Trips Each Dwelling Unit @$80
Additional Inspection Trips $20
Investigative Fee
Reinspection Fee C�a $20
total fee is
I hereby certify that I inspected ihe eledrical insfallation described herein on the dates stated: �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12
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Ltl_��/� Rough-in Inspection Required? ❑Yes�o Inspection Other Than Rough-In:�Ready Now ❑ Will Call
� You must call the inspector when ready! Date Ready:
I certify that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at
Job Site SVeet Address City
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Name
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e Fire No. County /
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Please Provide Two (2) Phone Numbers Including
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�ntractor License Number Master Electrician or Power Lirr
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Please Provid wo (2) Ph ne Numbers Induding
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RICITY COPY EB-00oo