P - 76522REQUEST FOR ELECTRICAL INSPECTION
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1�"J �+ 7 3 6 7 Minnesota Board of Electriciry
� 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 T'fY/MRS 1-800-627-3529 -
www.electricity.state.mn.us
Identify the wark covered by this request:
I ❑ NEW �(iEMODEL ❑ ADDITION ❑ REPAIR LU[.�� �(� �''�'1''`� / %�. � I � �
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traific Si nal Standard �$5
0 to 400 Am ere (� $25 Su lemental Fee �$20
401 to 800 Am re �$50 Transfortners u to 10 KVA �$10
Above 800 Am re �$75 Transformers over 10 KVA �$20
IRCUITS / FEEDERS Transfortner / Power Su for Si ns / Outline ' htin �$5
0 to 200 Am re �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re�$10 Includes the Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspeclion Trips Each Dwellin Unit � E60
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional In ion Tri �$20
Each S tem Device or ratus �$.50 Investl tive Fee
ADDITIONS TO THE 6ENERAL FEES Reins 'on Fee �$20
MULTIFAMILY DWELLINGS PER UN TOTAL FEE
3 to 12 Units �$50 Per Unit (minimum tot81 fee is $20) •/
Each Additbnal Unit � a25 'n" "�Ta' � °��
OTHEA ADDITIONAL Ny i
Li hti ReVofit �$25 r FoRure �/
Center Pivot Irti atlon Baom �$40 r��,�L_ �c,�,,,,[Y .��Q,= �3 „�:ss-
Manufactured Home Park Lots � a25 � nereby certity that I' e�ectrical iretauaeon bed nerein on �ates s�ated:
Recreational Vehicle Park Sites � E5 fl01GH" �^�
rate Bondi In ' � $20 � ,��— �
S ial Ins 'on ��330 r Hour "'��10N �pT�
Spedal Inspection �$.31 per Mile � 7�/� %�
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❑ LICENSED CONTRAGTOR ❑ COMPANY �OWNER and hereby request ir�speclia� ot the electrical work �
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