P - 76521�--�-r
RE�UEST-FOR EtECTRICAL INSPECTION � '�
Minnesota Board of Electricity �
��- 3 8 5 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
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(651) 642-0800 TT'(/MRS 1-800-627-3529
www.electriciry.state.mn.us I
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❑ NEYV ❑ REMODEL f�ADDITION ❑ REPAIR p�r � htin Stardard �$1
GENERAL FEES T�� Si nal Standard �$b ry
..�...,�..re. i en�u[o CI IPPI IFS _ .. �__ � enn �.
��5 Transfortners u to 10 KVA �$10
��� Transformers over 10 KVA �$20
��$75 Transfortner I Power Su for S' ns I Oulline Li htin �$5
�� ONE & TWO FAMILY DWELLINGS, EACH UNIT
��$�� Includes the Service andlor Power Suppty up to 500 Amperes, PJI
iION, REMOTE CONTROL, SIGNALING Circuits and Two Ins 'on Tri Each Dwellin Unit �$B(
OF LESS THAN 50 VOLTS Additanal Ins 'on T� �$�0
�ce or Aoaaratus �$.50 Investi ative Fee
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total fee is
Center Pivot I� aUon Boom �$40 ��reb certify that I inspected 1he electrica� �ns��e1� �� �� °� ��� �t�
Manufactured Home Park Lots � $25 '�
na� iN � U
Recreational Vehicle Park Sites � S5
rate Bondin Ins �on � � �w,re
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S'al Ins � n�$30 r Hour 'Z � 3 °i J� F_ �
S' I I ' �$.31 r Mile
i THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 1 MON � S
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