P - 777281-31G-074
.
IdeMity the work covered by this request:
❑ NEW � EMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re �$25
401 to 800 Am re �$50
Above 800 Am re � $75
CIRCUITS / FEEDERS
0 to 200 Am re �$5 p
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEE
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Li htin Retrofit (� $25 er Fixture
Center Pivot I' ation Boom �$40
Manufactured Home Park Lots � $25
Recreational Vehide Park Sit 7�t :�'
RE(�UEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 •�ft"j�0� / - _
www.electricity.state.mn.us "'� 7
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Outdoor Li hGn Standard � $1
Traffic Si nal Standard � $5
Su emental Fee � $20
Transformers u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transformer / 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
GNALING Circuits and Two Ins on Trips Each Dwellin Unit �$8(
AddiUonal Insoection Tri�s � $20
5 ial Ins ion �$30 r Hour ""F�
S ial I ection �$.31 r Mile �
THIS INSTALLATION MAY BE ORDERED DISCONNECT
FOR OFFICE USE ONLY
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Fee �
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nimum total fee is $20) ��
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described herein on the dates stated:
o�h
--� Ct -�6 —_ �
wh�` J-�,t_c
WITHIN 18 MONTHS
� �3;� �-
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
E&OOOOtA-13 7/tlZ000 BOAND OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY