P - 76412REQUEST FOR ELECTRICA�
�� 101 � 318 � Minnesota Board of Electricity f"�
1821 University Avenue Suite S-128, Saint P
(651) 642-0800 TTY/MRS 1-800-627-3529
Describe -using the back of the white copy if necessary - the work covered by this request:
� � �
GENE FEES Outdoor Li hting Standarc
SERVICES / POWER SUPPLIES T.�rr� e�,,.,�i a�...�.,,.� n
Above 800
,UITS I FEE
0 to 200 Ar
)MMUNICATION, REMOTE CONTROL, SIG
CIRCUITS OF LESS THAN 50 VOLTS
iystem Device or Apparatus @ $.50
ADDITIONS TO THE GENERAL FEES
TIFAMILY DWELLINGS (PEI
3 to 12 Units @$50 Per Unfl
Each Additiona� UnR @ $25
OTHER AD
Lighting Retrofd @ $.25 per F
Center Pivot Imaation Boom �
THIS INSTALLATION MAY BE ORDERED
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� Transformers up to 10 KVA $10
� Transformers over 10 KVA $ 20
Transformer / Power Supply for Siqns I Outline Liqhtinq .$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Fee
TOTALFEE
total fee is $201 �� �
I inspeded the elecirical installafion described herein on ihe dates stated:
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) IF NOT COMPLETED WITHIN 12 MONTHS __�
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Date: Rou h-in Ins
�/�/� � g pection Required7 ❑ Yes o Inspecfion Other Than Rough-In: ❑ Ready Now ill Call
You must call the inspector when ready! Date Ready:
I certify that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work afi