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P - 81865REQUEST FOR ELECTRICAL INSPECTION .� O� 7 ��� tl s 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 Identity the work covered by thi eque � ❑ NEW ❑ REMODEL ❑ ADDITI � REPAIR /��� � � �ili(� �� � � GENERAL FE S Outdoor Li htin Standard �$1 SERVICES ( POWER SUPPLIES Traflic Si nal Standard �$5 0 io 400 Am ere �$25 Su lemental Fee �$20 401 to S00 Am ere �$50 Transformers u to 10 KVA �$10 Above 800 Am ere �$75 Transformers over 10 KVA �$20 CIRCUITS / FEEDERS Transformer / Power Su I for Si ns / Outline Li htin �$5 0 to 200 Am ere �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT Above 200 Am ere �$10 Includes the Service andlor Power Supply up to 500 Amperes, All ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Tri s Each Dwelling Unit �$80 CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ction Tri s�$20 Each S stem Device or A aratus �$.50 ' Investi ative Fee ADDITIONS TO THE GENERAL FEES Reinsoection Fee �$20 3 to 12 Units �$50 Per Unit �minimum io�ai �ee is yco� Each Additional Unit �$25 FOR MSVECTOq USE 0lbY OTHER ADDITIONAL FEES Li tin Retrofit �$25 r Fixture Center Pivot Irri ation Boom �$40 ManufactuPed Home Park Lots � I her ce' that I ins ed tl�e electrical insNallation described herein on the detes stated: Recrea6onal Vehicle Park Sites � "a"'"'" °�'� arate Bondi los (� $20 S ial Ins ection �$30 er Hour "�""�"`�"«' /r �DA7E S ial Ins ection �$.31 r Mile �� �� `'� THIS INSTALLATION MAY BE ORDERED DISCONNECTED I OT COMPLETED WITHIN 18 MONTHS FOR OFFICE USE ONLY IIN1111llllllilllllilllllll�fllll�I�11111lI a��� • 3� i D 9 7 8 5 7 5�E �� �� � Request Date: Rough-in Inspedion Required? ❑ Yes No Inspection Other Than Rough-In: Ready Now [] Will Call — �� You must cal! llie inspeqor when ready! Date Ready: i certiiy that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work ai Job Address (Street. x. or Route No.l � � "-° �� --- � --- � �� Zfo Code 1 _ . � � Section � Township `� � Range � Power �� � ss (Contractor, C ny or Owner Perfo Installation) > Q,-�l� S�'�rl �nature (Contractor ompany or Owner Pertortning Installation) Phone < 3 7/1/2000 BOAiiD OF ELECTRICITY COPY INSTRUCTpNS ON BACK OF�YELL COPY