P - 78840REQUEST FOR ELECTRICAL INSPECTION
1 3 3 2 312 Minnesota Board of Electricity
� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
Identify the work covered by this request:
� JEW ❑REMODEL ❑ADDITION ❑REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am ere � $75
IRCUITS / FEEDERS
0 to 200 Amoere � SS
npere � $t0
JICATION, REMOTE CONTROL, SIG
IITS OF LESS THAN 50 VOLTS
Device or Apparatus � $.50
DDITIONS TO THE GENERAL FEES
MULTIFAMILY
3to12Ur
OTHER
LighUng Retrofit � $25 G
Center Pivot Irriaatbn Ba
Outdoor
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Supply for Signs / OuUine Lightirg �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Suppty up to 500 Amperes, All
Circuits and Two Ins ec6on Trips Each Dwellin Unit �$BQ
Add'Aional Ins ection Tri s�$20
Investi ative Fee
Reinsoeclion Fce � �20
total fee is
ManUfactured Home Park Lots �$25 ereby certty that I inspected aie elecMCa� inslaAaeon described herein on tlie da�s smp
Recreational Vehicle Park Sftes �$5 '� �" o��
Se rate Bondi In ion �$20
S ial I 'on �$30 r Hour �"�^a+ onre
S ial Ins ecUon �$.31 r Mile lCS '� b'
� THIS INSTALLATION MAY BE ORDERED DISCONNECTE OT COMPLETED WITIiIN 18 MONTH
FOR �FICE l�E ONLY
I illlil Illil Illil lilil IIIII 1NII 11111 IIIII IIII IIII
* 1 3 3 2 3 1 z 6�
I certiry that �
EB-OOOOtA-13
BOAiiD OF ELECTRICITY COPY
� .�
inspection of tf� electrical work at:
INS7RUCTpWS ON�BACK OF YELLOW COPY