P - 78187REQUEST FOR ELECTRICAL INSPE TION
1� y, Minnesota Board of Electriaty ��
` ,f � ������ � 1821 University Avenue Suite S-128, Sairrt Paul, Minnli�oTa 55104
(651) 642-0800 TTY/MRS 1-800�27-3529 www.elec�'icity.state.mn.us
❑ NEW ❑ REMODEL ❑ ADDJTIQN C� REPAIR Describe -using the back d thq white cqpy if necessary - t�e work cov�ed by this request:
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GENERALFEES
SERVICES / POWER SUPPLIES
0 to 400 Amoere � E25
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
3 to 12 Units @ S50 Per Un
Each Additional Unit � y25
Lighting Retrofit @ $.25 per Fixture
Center Pivot Irtiaation Boom � &4(
I cer�
Su dement� Fee $20
Transformers u to 10 KVA $10
Tr�sfamers over 10 KVA $ 20
Transfortner / Power Su I for Si ns I Outline Li htin $5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Senice andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit � 380
(minimum total fee is $20) ���( V�J C/
THISMfAFORN6PECTOR Y
1 hereby cerUfy Mat 1 i�ected Ihe elatrital insfaNaUOn described herein on Ihe da�s staBed:
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I(I�I II III II III II III II II� II III II II� II III �� I� �
15742216 ��,
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CONTRACTOR ❑ CONPANY ❑ OWNER and hereby request i�speciion of the electrical wak at: