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P - 796441-202-573 ��ma N Identity the work covered by this request: ❑ NEW ❑ REMODEL ❑ADDITION GENERAL F SERVICES / POWER SUPPLIES REQUEST FOR ELECTRICAL INSPECTION Minnesota Board of Electricity — 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-500-627-3529 ' ,.....� www.electricity.state.mn.us •�I��G� '�� � ��� p►�l-e Gf k ������ v��p.'s (lutdnnr I iahtina Standard � $1 0 to 400 Am re �$25 401 to S00 Am re �$50 Above 800 Am ere � $75 CIRCUITS / FEEDERS 0 to 200 Am re �$5 Above 200 Am re � $10 ALARM, COMMUNICATION, REMOTE CONTROL, SfGI CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Each S stem Device or A aratus �$.50 annmoNS To THE GENERAL FEES Uniis � $50 Per Unit Iditional Unit � $25 OTHER ADDITIONAL FEES Retrofit � $25 per Fixture 'ivot Irrigation Boom � $40 lured Hane Park Lots �$25 1 onal Vehicle Park Sifes � $5 Traffic Si nal Standard 8$5 Su lememat 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 andlor Power Supply up to 500 Amperes, All Circuits and Two Inspection Trips Each Dwellin Unit �$8C Additional Inspection Trips � $20 Investiaative Fee — that I total fee is S ecial In ion �$.31 r Mile '' THIS INSTALLATION MAY BE ORDERED DISCONNECTED __NOT COMPLETED WITHIN 18 MONTHS . Fon o�cE usE orur 1� 1� 1-( 2 O �.�J� I ������� �ir�� ��«� �i�1111�11 Ellll li�i� ����1 ��i� ���� � � 1� o z 5�� o� ,�'�' ��7� ao.sv I fi est Da e: Rough-in Inspection Required? ❑ Yes o Inspection Other Than Rough-In: ❑ Ready Now Will Ca�l � �� You must call the inspector when ready! Date Ready: I cert'rfy that I am the �IICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspeclion of the eledrical work at: