P - 75891REQUEST FOR ELECTRICAL INSPECTION
� � � � � � 9 � � � Minnesota Board of Electricity
1821 Universitp Avenue Suite S-128, Saint Paul, Minnesota 55104
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(651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
D� g the th whde copy th rk b this request:
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GENERAL FE S Outdoor Ligh' g Standard @$1
SERVICES / POWER SUPPLIES Trafflc Sianal Standard na $5
Above 800 Am ere $75
IRCURS/FEEDERS
0 to 200 Am ere a$5
Above 200 Am re $10
ALARM, COMMUNICATION, REMOTE COMROL, SIG
CIRCUITS, CIRCURS OF LESS THAN 50 VOLTS
Each S em Device or A s@$.50
ADDRIONS TO THE GENERAL FEES
3 to 12 Units @$50 Per
Each Addttional Unft a(� S
ONE & TWO FAMILY DWELLINGS, EACH UNIT
�ncludes the Service and/or Power Suppty up to 500 Amperes, M
Circwits and Taro Inspectian Trips Each Dwelling Unit @$80
Addfional Inspection Trips � $20
Im�tiaative Fee
TOTAL FEE
total fee is $20) ��
I hereby certHy that I Inspected the elecMcal U�Ilatlon dagalbed hereln on the detes slated: I
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s 'on � $30 r Hour °�D1A�ID0°�'0 �—�
�on @ $.31 per Mile
ALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLEI'ED WITF
�QR OF�tCE USE ONLY
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g pedi R� o Inspedion Other Than Rough-In: eady Naw Call
�+ b� u must call the h�s�r when readyl Dete Ready.
1 certify tlrat I am the CENSED CONTRACTOR O COMPANY ❑ OWNER and hereby request inspection of the electrical work at
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