P - 79839-1-307-509 ��6:
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Identity the wo c covered by this request:
❑ NEW REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES I POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am re � $75
CIRCUiTS / FEEDERS _ .,. . _ i
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity "°�
1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3�$.Q /„ ; �
www.electricity.state.mn.us y %��-j
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Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUtTS, CIRCUtTS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 UnRs �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Li hb Retrofit �$25 r Fixture
CeMer PNot Irriaabon Boom � S40
Outdoor Li htin Standard (� $1
Traffic Si nal Standard � $5
Su �lemental Fee � $20
Trensformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li hti� �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Additional Ins ion Tri C� $20
Investi ative Fee
Reinsoection Fee (� $20
total fee is
i�taNaSon described herein on Ihe dates stated:
Recreational Vehide Park Sites � $5 "`""""" """
Se rate Bondin Ins ection �$20
S ial Ins 'on �$30 r Hour """`"'�"`�TON °"'�
S ecial In ion �$.31 r Mile c f Q�
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
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Reque Date: Rough-in Inspection Required? ❑ Yes o Inspection Other Than Rough-In: ❑ Ready Now ill Call
2� Q� You must call the inspec[or when ready! Date Ready:
I certity that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the eledrical wotk ah
Job Address (Street, Box, or Fioute No.) City Zip Code
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Section Township Range Fire No. County
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E&00001A-13 7/1/2000 AqD OF ELECTAICT' COPY INS7AUCTIONS ON BACK OF YELLOW COPY