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P - 798051-2��3-358 � EW ❑ REMODEL ❑ ADDITION ❑ REPAIR GENERAL FEES IVICES / POWER SUPPUES 0 to 400 Ampere (� $25 401 to 800 Ampere � $50 Above 800 Amoere � $75 REQUEST FOR ELECTRICAL INSPECTION Minnesota Board of Electricity 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-500-627-3529 �.... � www. electricity. state. mn. us � �'r�l� !:�.� 0 to 200 Am ere (� $5 Above 200 Am ere (� $10 ALARM, COMMUNICATION, REMOTE CONTROL, SIGi CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Each S stem Device or A aratus �$.50 ADDITIONS TO THE GENERAL FEES MULTIFAMILY DWELLINGS PER UNI 3 to 12 Units �$50 Per Unit Each Additional Unit � $25 OTHER ADDITIONAL FEES Li htin Rehofd �$25 er Fixture Center Pivot Irri ation Boom �$40 Manufactured Home Park Lots � $25 Recreational Vehicle Park Sites � $5 Outdoor Lighting Standard � $1 Traffic Si nai Standard � $5 Su lemental Fee � $20 Transiormers u to 10 KVA �$10 Transformers over 10 KVA � $20 Transformer / Power Su 1 for Si ns I Outline Li htin (� $5 ONE & TWO FAMILY DWELLINGS, EACH UNIT Includes the Service andlor Power Supply up to 500 Amperes, All Circuits and Two Inspection Trips Each Dwellin Unit �$8( Additional Inspection Trips � $20 Investi ative Fee Reinsoection Fee � $20 ipecial Inspection �$.31 per Mile I I THIS INSTALLATION MAY BE ORDERED DISCONNECTI FOR OFFICE ll8E ONLY ! Illi1111111 Illll llill llill Illll Ilill IIIII Ilif 1111 �E 1 Z c 3 3 5 8 1�t that I insoected the total fee is herein on the 2 �j' -03 �MONTHS ._��� ���� � so � Request te: Raugh-in Inspection Required? ❑ Yes o InspecUon Other Than Ro gh-In: Fieady Now �J WiN Cal! f� ���/ �_ You must call the inspector when ready! Date Ready: �)��� � I certi(y t�at I am the ❑ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electricai work at