P - 79691REQUEST FOR ELECTRICAL INSPECTION
1Q(� Minnesota Board of Electricity �
1� 2 4 3� 1./ V '��fi 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� (651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us -�►-�.�... '� '
Identify the work covered by this request:
❑ NEW MREMODEL ❑ ADDITION ❑ REPAIR �� ` � ` �� �"� \�� � h a � r��-��
GENERAL FEES Outdoor Li htin Standard (� $1
SERVICES / POWER SUPPLIES Traffic S' nal Standard �$5
0 to 400 Amcere �$25 i Suoolemental Fee �$20
Above 800 Amoere �
0 to 200 Ampere �
IMMUNICATION, REMOTE CONTROI, SIGNALING
CIRCUITS OF LESS THAN 50 VOLTS
ADDITIONS TO THE GENERAL FEES
_TIFAMILY DWELLINGS (PER UNI�
3 to 12 Units (� $50 Per Unit
Each Additional Unit � $25
Manufaciured Home Park Lots �
Recreational Vehicle Park Sites �
� $30 per Hour
� $.31 oer Mile
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Suppry for Signs / Outline Lighting �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/a Power Supply up to 500 Amperes, All
Circuits and Two Inscection Trips Each Dwelling Unit f� $8(
Fee
Fee �
total fee is
I inscected the elechical insfallatlon described herein on the de�s sMated:
IIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLE
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I certify that I am the ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: