P - 76351REQUEST FOR ELECTRICAL INSPECTION � '
��� �A ��� Q o� Minnesota Board of Electricity
�°�-� �� 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(6�800 TTY/MRS 1-800-627-3529 www.e[ectricity.state.mn.us
I SERVICES / POWER SUPPLIES
ALARM, COMMUNICATION, REMOTE CONTROL
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
� Each Svstem Device or Aooaratus C�D $.50
CeMer Pivot Irrivation Baom
I cerEiFy thati
Su lemental Fe.e @ $20
Transformers u to 10 KVA a$10
Transformers over 10 KVA $ 2(I
TransFormer 1 Pawer Su I for Si 10uUine Li hti $5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includ�s the Service and/or Power Suppty up to 500 Amperes, All
Circuits and Two Inspeetion Trips Each Dwelling Unit @$80
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total fee is
i�,��,�_ �r[?�7['��n�+�t�rr?.��,?:-lT�rr�r�-r,,rt�■
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pection @ $.31 rlNae
►LLATION MAY BE ORDERED DISCONNECTED IF:NOT COMPLETED WITHIN 12 MONTHS
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���a��I��������I��I�III������QIlIO��� � MAY — � 200;
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� Rough-in Itispectlon R�uired7 ❑Y Inspectlon OthazThan h-1 • ow OWiil Call
You must call the inspector when readyl Date Ready:
n the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby est inspection of the �ectrical work at
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c;antractor ucense rvumuer master rreariden or
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