P - 786891-36�-101 ��k `P
work covered by this request:
❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
0 to 400 Amoere �
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electriciry
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us
G.����-
RCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGN,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS '
Each S tem Device or ratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Unils �$50 Per Unit
Lighting Retrofit � $.25 per Fbcture
CeMer Pivot Irrigation Boom � $4C
Manufactured Home Park Lots � $
Recreational Vehide Park Sites �
Treffic Si nal Standard � $5
Su � lemental Fee � $20
Transformers u to 10 KVA (� $10
Transfortners over 10 KVA � $20
Transformer / Power Su for S' ns / OuHine Li Min �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, All
Circuits and Two Ins ectlon Trips Each Dwellin Unit �$8f
Additional Ins ection Tri s�$20
Investi ative Fee
Reinsoection Fee � $20
3P�3
total fee is
the electrical instaNetian described herein on Ihe
5 iai ins on ��:tu r rrour -- --�— � 2�.� I
Special Inspec�on �$ 31 per Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFICE USE ONLY
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Requ ate: Rough-in Inspectan Required? ❑ Yes No Inspection Other Than Rough-In: ❑ Ready Now wll Call
3� �� You must call the inspec[or when ready! Date Ready:
I certi(y that I am the�ENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical wrork at:
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EB-00001A-13 7/t/2000 BOAHD OF ELECTRICRY COPY IN37AUCTIONB ON BACK OF YELLOW COPV