P - 78682REQUEST FOR ELECTRICAL INSPECTION
� ��^ �� O Minnesota Board of Electricity
� r� 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
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(651) 642-0800 TTY/MRS 1-800-627-3529
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� www.electricity.state.mn.us
Identify the work covered by this request: �V �C� C�}-/�� 6'F ��V i�� �v
❑ NEW ❑ REMODEL ❑ ADDITION EPAIR � �"����
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES /�7 .� � Traffic Si nal Standard �$5
0 to 400 Am ere �$25 U/
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am re �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
Su lemental Fee � $20 " �
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortner / Power Su for Si ns / Outline Li htin �$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspeclion Tri s Each Dwellin Unit �$8f
Additional Inspection Trips � $20
Investiaative Fee
TIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unft
Each Additional Unit � $25 F0F �"s"�fOP � °"�
OTHER ADDITIONAL FEES
L' htin Retrofit �$25 er Fixture
Center Pivot Irri ationBoom � $40
Manufactured Home Park Lots �$25 I hereey cert' mat i
Recreational Vehicle Park Sites �$5 "�' M
Se arate Bondin I ion (� $20
S ial Ins ection �$30 r Hour `�"` �P�'"10N
S ecial Ins ection �$.31 r Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED II
m total fee is $20) �
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described herein on the da� stated:
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Request Date: Rough-in Inspectlon Required? ❑ Yes o Inspection Other Than Raigh-In: ❑ Ready Now iil Call
f� �� � You must call the inspeclor when ready! Date Ready:
I certi(y that I am the � �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of tlie electrical work at
EB-00001A-13 7/1/2000
BOARD OF ELECTRICRY COPY msrriu���� w', en�n vr re��vn ....r.