P - 78752REQUEST FOR ELECTRICAL IN�£GTIQN
�,, � 4 71-113 � Minnesota Board of Electricity
1821 University Avenue Suite S-128, Sairrt Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
❑ NEW ❑ 3E�dQDEL ❑ ADDITION REPAIR Describe -using the back of the white copy'rf necessary - ihe work covered by this request:
GENERALFEES
401 to 800 Am re $50 Transformers u to 10 KVA $10
Above 800 Am re E75 Transformers over 10 KVA $ 20
CIRCUITS I FEEDERS Transiortner / Power Su I for Si ns I Outline L' htin $5
O to 200 Am e$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am e$10 Includes ihe Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Txro Inspection Tri{u Each Dwelling Unit @ i80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Addition� Ins tion Tri $20
Each S stem Device or atus $.50 Inves' ative Fee
ADDITIONS TO THE GENERAL FEES Reins tion Fee $20
MULTIFAMILY DWELLIN�S PER UNI TOTAL FEE '
3 to t2 Units @ S50 Per Unit (minimum total fee is $20) �
Each Additional Unit � $25 TMISAREAFORIMSPECTORIAEdiY
I he�eby ceN(y tl�at I inspected the electrical insfaqa6on desaibed here� on Ihe da�
OTHER ADDITIONAL FEES �2 /�j ,
Linhtina Retrofit � 5.25 cer Fi#u2 ��
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Rough-in InsPeqion Required? ❑ Yes Inspedion Other Than RougMn: OReady Nwv I Call
You must call Vie inspeda when ready! Date Ready.
I certity U�at I am 1he [�I,ICENSED CONTRACTOR 0 COMPANY ❑ OWNER and hereby request �tion oi tl�e �tri�� w� �:
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