P - 81907REQUEST FOR ELECTRICAL INSPECTION
1���2 6� J U� Minnesota Board of Electricity
1821 University Avenue Sufte 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 this request:
❑ NEW � REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES Outdoor Li htin Standard �$1
SE VICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am re �$25 '.� v Su lemental Fee �$20
401 to S00 Am re �$50 Transformers u to 10 KVA (� $10
Above 800 Am ere �$75 Transformers over 10 KVA �$20
CIRCUITS / FEEDERS Transformer / Power Su I tor Si ns / Outline Li htin C� $5
0 to 200 Am re �$5 (� � :' L ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$10 - Includes the Service and/or Power Supply up to 500 Amperes, NI
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwellin Unft �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ion Tri s(� $20
Each S tem Device w A aratus �$.50 Inves' ative Fee
ADDITIONS TO THE GENERAL FEES Reins 'on Fee �$20
MULTIFAMILY DWELLINGS PER UNI t. ,/� TOTAL FEE
3 to 12 Units �$50 Per Unit or��' ,-:� '.%+:.��,,`_, (minimum total fee is $20)
EaCh AddItl00fll Unit �$25 � INSPEGTOR USE ONLV ���q
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Center Pivot Irtigation Boom � $4
Manufactured Home Park Lots �
Recreational Vehicle Park Sites �
Seoarate Bondina Insoection � $�
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I herebvi certilv that I insoected the electrical insfallation described herein on tlie dates sNated:
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FOR OPFICE USE ONLY �' ' "� � �
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Request DA�: Rough-in Inspection RequiredT �]"Ves ❑ No Inspection Other Tban Rough-In: ❑ Ready Now iil Call
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I ceRity that I am the �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecti�on of the electricaf work ah
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EB-00001A•73. 7/1/2000 ���� BOMD OF ELECTRICRY COPV INSTFIUC710NS ON BACK OF YELLOW COPY