P - 78987REQUEST FOR ELECTRICAL INSPECTION
'� Minnesota Board of Electricity '�
P� 3 3 7- 4 7 4 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
Identity the work covered by this request:
NEW ❑REMODEL �ADDITION ❑REPAIR �j �✓�� vf I
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am re �$50 Transformers u to 10 KVA �$10
Above 800 Am re �$75 Transformers over 10 KVA �$20
CIRCUITS / FEEDERS Transformer / Power Suoolv for Sians / Outline Liahtina �$5
ALARM, COMMUNICATION, REMOTE COPfTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or ratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
OTHER ADDITIONAL FEES
Lightlng Retrofit � $.25 per Fixture
Center PNot Irrigadon Boom � $40
Manufactured Home Park Lots �$2�.� �
Recreational Vehicle Park Sites � $5ti
� $.31 cer Mile
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Ins ection Trips Eac Dwellin Un't �$8(
Additional Ins ion Tri s(� $20 '
Investi ative Fee
Reinsoection Fee � $20
FOR OFRCE USE ONLY
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I certi(y that I am the
EB•00001A-13 7/1/Z000
TOTAL FEE I,lA,
total fee is $20) «
I insoect� the electrical installatian desaibed herein on the dates sfa�d:
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COMRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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BOARD OF ELECTqICRY COPY
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WSTFiUC710NS ON BACK OF YELLOW CAPY