P - 80521REQUEST FOR ELECTRICAL INSPECTION
1�5 7 g g g Minnesota Board of Electricity —
� � �""��.. 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
��� (651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state . s " '
IdentiTy the work covered by this request: � � R C�j[�[
❑ NEW ❑ REMODEL ❑ADDITION ❑ REPAIR
GENERAL FEES Outdoor Liphting Standard �$1 _
0 to 400 Ampere �
Above 800 Ampere
�UITS / FEEDERS
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIG'
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unft
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Center Pivot Irtigation Boom � $
Manufactured Home Park Lots �
� S30 cer Hour
Traffic Si nal StandaM (� $5
Su demental Fee (� $20
Transformers u to 10 KVA (� $10
Transformers over 10 KVA � $20
Transiormer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$80
Additional Inspection Trips � $20
Imestiaative Fee
total fee is
electricel installatlon d�aibed herein on
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IFI�OT COMPLETED
�/
I certi(y that I am the "� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at