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❑ NEW ❑ EMODEL ❑ ADDITION
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GENERALFEES
SERVICES I POWER SUPPLIES
ALARM, COMMUNICATION, REMOTE CONTROI
CIRCUITS, CIRCUITfi OF LESS THAN 50 VOLTS
Each System Device or ApparaWs @ E.50
ADDITIONS TO THE GENERAL
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units @$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEE:
Lighting Retrofit � $.25 per Fixture
�Center Pivot Irriaation Boom 6D E40 �
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Sairrt Paul, Minnesota 55104
(651) 642-0800 T7Y/MRS 1-800-627-3529 www.electricity.state.mn.ur
R Describe -using the back of the white copy'rf� n� ary - the wo covered by this request:
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Includes the Senice andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling U�it �$80
TOTAL FEE I ���
(minimum total fee is $20) ��
rH�s atEa Fat ira�croa use orxr
I hereby cerUry that I inspecled the electrical installa6on deuribed herein on the da6es sta0ed:
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CONTRACTOR ❑ COMPANY ❑ OYVNER and he�eby request inspec�on of tl►e e�Ctric�l wak at:
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