P - 783071--�56-836
Identity the work covered by this request: /j��
❑ NEW EMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES I POWER SUPPLIES
0 to 400 Am re �$25
401 to 800 Am re�$50
Above 800 Am re � $75
CIRCUITS / FEEDERS
0 to 200 A re �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each em Device or aratus �$.50
ADDITIONS TO THE GENERAL FEE
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
R�QUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 -
www.electricity.state.mn.us ?�'r� �p� ��
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Outdoor Liahtina Standard � $1
Supplemental Fee � $20
Transformers uo to 10 KVA �
� Transformer / Power Suppy for Signs / Outline Lighdng �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Inciudes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellina Unit �$8(
Fee
Fee �
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total fee is
Center Pivot Irri ation Boom �$40 •
ManufaCtured Home Park Lots �$25 I hereby ce that I in ed the electrical installatbn described herein on the dates stated:
Recreational Vehicle Park Sites � �"'" � ��
Se arate Bondi In 'on � $20
S'al Ins 'on �$30 r Hour Fl""""�`�i10N _ 25 ��
S ial In ' n�$.31 r Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
— FOR OFFICE 1l8E ONLY �� ��v l
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Request Date: , Date Ready: � �� �i � d 3
I D _/� O� Y m�i �p the inepector when �eady.
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I certity that I am the �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspect� �f the electrical work at:
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NO D OF ELECTRICRY C�PY � ��TR�T�S � sACK OF YELLOW�