P - 78641REQUEST FOR ELECTRICAL INSPECTION
� ��� g 3 g Minnesota Board of Electricity
1� � m 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
the work covered by this request:
' ❑REMODEL ❑ADDITION ❑REPAIR
0 to 400 Am ere �$25 /) � 1
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus �$.50
.TIFAMILY DWELLINGS (PER
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortner / Power Su for Si ns / Outline L' hti �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each DweNin Unit �$8L
Additional Insoection Trios � $20
U /5
Li Min Retrofit �$25 r Fixture
Center Pivot Irri ation Boom �$40
Manufactured Home Park Lois �$25 1 hereby cee
Recreatlonal Vehicle Park Sites � $5 "01GM1N
Se arate Bondin Jns ection �$20
S ial Ins ection �$30 r Hour """ "'�'K
S ial Ins ection �$.31 er Mile
tHIS INSTALLATION MAY BE ORDERED DISCONNECT
FOR OFFICE USE ONLY
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Fee � $20
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I insoected the eleclrical
total fee is $;
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on Me dates stated:
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I certiiy that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER arni hereby request inspection of the electrical work at:
EB-OOOOlA-13 7/1/2000 60ARUOFELE{:IXI{:11�4VYT ���nu�.�i�navnuw�.nvr�c«v��vv�.