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P - 80110REQUEST FOR ELECTRICAL INSPECTION 1 � ,,, � � � � �� Minnesota Board of Electricity - _�,j � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 �- � (651) 642-OS00 TTY/MRS 1-800-627-3529 ' www.electricity.state.mn.us " ' ❑NEW ❑REMODEL ❑ADDITION ❑REPAIR GENERAL FEES SERVICES / POWER SUPPLIES 0 to 400 Am re �$25 401 to 800 Am ere (� 0 Above 800 Am re � 75 CIRCUITS / FEEDERS 0 to 200 Am re �$5 Above 200 Am re � $10 ALARM, COMMUNICATION, REMOTE CONTROL, SI CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Each S stem Device or A aratus �$.50 ADDITIONS TO THE CaENERAL FEE MULTIFAMILY DWELLINGS PER UNI 3 to 12 Units �$50 Per Unit Each Additional Unit � $25 Manufactured Home Park Lots � Recreational Vehicle Park Sites � Su lemental Fee � $20 Transformers u to 10 KVA �$10 Tra�formers over 70 KVA � $20 Transformer / Power Su I for Si ns / OuHir�e Li htin C� $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 Dwellin Unft �$8( Additional Ins ection Tri s�$20 Investi ative Fee Reins�ection Fee � $20 total fee is S ecial In ion �$30 er Hour -" v V F'""""�GTO" � Special Inspection � $.31 per MMil�e THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN FOR OFFlCE USE ONLY 14{�Ill Il�il i�lli illil lllll {�1111111111111IIII I��� �j3�� , �E 1 Z B 1 S 4 4 4� �- J 30. So on U�e dates slatad: o�re a� 7?�3" oah _ /D��-o� ���� Now I�l Will Call � �i(.� Qj( � You must call the inspec[or when ready! � Date Ready:^(�,�' � f�� � i_ ,��/� � I certify that I am the �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at