P - 81800� REQUEST FOR ELECTRICAL INSPECTION
� 1� � J �-10 9�q ,- Minnesota Board of Electricity
1821 University Avenue 5uite S-128, Saint Paul, Minnesota 55104
��� (661) 642-OS00 TTY/MRS 1-800-827-3528
www. electrici ty. state. mn. us
Identity the work covered by this request: ,.`. _- �
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W O REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES Outdoor Li h6n Standard �$1
SERVICES / POWER SUPPIIES 7raffic Si na! Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am re �$50 Trensformers u to 10 KVA �$10
Above 800 Am re �$75 Transformers over 10 KVA �$20
CIRCUITS / FEEDERS Tra�sformer / Power Su for S� ns / Outline Li htin � S5
0 to 200 re �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re �$10 Includes the Service andlor Power Suppty up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Ins an Trips Each Dwellin Unit �$80
CIRCUtTS, CIRCUITS OF LESS THAN 50 VOLTS Additional I ' Tri s�$20
Each S tem Device or ratus �$.50 Investl ative Fee
ADDITIONS TO THE GENERAL FEES Rein 'on Fee �$20
MULTIFAMILY DWELLINGS PER UNI TOTAL FEE
3 to 12 Units �$5o Per Unit (minimum total fee is $20) ��5�
Each A�iitional Unit �$25 �p ��PECTOp USE ONLY
OTHER ADDRIONAL FEES
that I insoected the electrical ir�taNaban desxibed
Recreational Vehicle Park SRes � $5 '""""' ""
S rate Bondin I ' � $20
S ial In 'on �$30 r Hour ""`
' I I ' � $.31 r Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF N
FOR OFFICE U8E ONLY
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I certity that I am the �ENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the elec4rical work aY.
rob Address (Street, Box, w Route No.) Ciry Z�p Ca1e �
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I Electrical CaRractor / Canpany Name
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