P - 79861REQUEST FOR ELECTRICAL INSPECTION
���(� e Minnesota Board of Electricity "°�
J 2� 5 7 7 �" "' 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
��e�; (651) 642-0800 TTY/MRS 1-800-627-3529
www.electrici .stnE,e: n.us '' '
Idertify the work covered by this request: ��
❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAfR �e� � � " �
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am�ere �$25 Su lemeMaf Fee �$20
I CIRCUITS / FEEDERS
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S em Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
Lighting Retro�t � $25 per Fixture
Center Pivot Irrigation Boom � $4(
Manufactured Home Park Lots � 9
Recreational Vehicle Park Sites �
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns ! Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
tncludes the Service ancllor Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$8(
Additional Insuection TriDS � $20
5pecial {nspection �$.31 per Mile � �
THIS INSTALLATION MAY BE ORDERED DISCONNECTI
FOR OFFICE USE ONLY
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(minimum total fee is $20) U •
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eledrical installatlon desaibed herein on the dates state
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ETED WITHIN 18 MONTHS
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ivah-In: eadv Now (l Will Call
� � You must call the inspector when ready! � Date Ready: �
I certity that I am the �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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E&00001A-13 7/1/2000 BOARD OF ELECTRICIIY COPY
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INSTHUCTIONS ON BACK OF YELLOW COPY