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P - 81597REQUEST FOR ELECTRICAL INSPECTION � Q%% Minnesota Board of Electricity 1� 0 4 5� V 1 1 182� University Avenue Suite S-128, Saint Paul, Minnesota 55104 i (651) 642-OS00 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us " ' Identify the work covered by this request: ,.� � ❑ NEW ❑ REMODEL ❑ADDITION �REPAIR GENERAL F S SERVICES / POWER SUPPLIES 0 to 400 Am ere �$25 401 to 800 Am ere �$50 Above 800 Am ere � $75 CIRCUITS / FEEDERS 0 to 200 Am ere �$5 Above 200 Am ere � $10 ALARM, COMMUNICATION, REMOTE CONTROL, SIG CIRCUITS, CIRCUITS OF LESS 7HAN 50 VOLTS Each S stem Device or aratus �$.50 ADDITIONS TO THE GENERAL FEES 3 to 12 Units �$50 Per Unit Each Additional Unit � $25 OTHER ADDITIONAL FEES Manufactured Home Park Lots � Recreational Vehicle Park Sites � Seoarate Bondina Insoection � $; Ouldoor Li htin Standard � $1 Traftic Si nal Standard (� $5 Su �emental Fee � $20 Transformers u to 10 KVA �$10 Transformers over 10 KVA � $20 Transformer / Power Su I for Si ns / Outline Li htin �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT Includes the Service and/or Power Supply up to 500 Amperes, All Circuits and Two Inspection Trips Each Dwelling Unit �$8( Additional Inspection Trips � $20 I insoected Me electrical installauon described herein on ihe dates stated: � v( � rHs I certify that I am the',� Job Address (Street, Box, or -� �,c . Section Township Occupant � ry , l'I CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: _ .�.. > w. - � � . n �� :� ,. _ S � �� �.. - ,�� a... . , . .,� + � � P��;��� _�I�� ,� — OF ELECTRICRY COPY T 1 ione ��� �s3� � 2�'y INSTRUCTIONS ON BACK OF �