P - 77618REQUEST FOR ELECTRICAL INSPECTION �'�
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� � Minnesota Board of Electricity � � �
- 1821 University Aven 8, Saint Paul, Minnesota 55104 �
� _ (651) 642-0800 /M 00- 27-3529 www.electricity.state.mn.us �"' '
Describe -usi the a�k of the white if necess - the work cqvered by ' re � -
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GENERAL FEES Outdoor Li hting Standard $1
SERVICES / POWER SUPPLIES Traffic Si nal Standard @$5
0 to 400 Amcere (� $25 Suoolemental Fee na $20
401 to 800 Am ere a$50
Above 800 Am ere $75
CIRCUITS I FEEDERS
0 to 200 Am re $5
Above 200 Am re $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus $.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNIT
3 to 12 Units @$50 Per Unit
FEES
Center Pivot Irri ation Boom a$40
Manufactured Home Park Lots $25
Recreational Vehicle Park Sites $5
Se arate Bondin Ins ion $20.
Special Ins ection $30 per Hour
S ial Ins ction $.31 per Mile
THIS INSTALLATION MAY BE ORDERED DI
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L8510339
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Additional Inspection Trips @ $20
investiqative Fee
total fee is
I hereby certiry that I inspected the electrical installafion described herein on the dates slated: �
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:X%REDIAfl4N00NED DATE
�TED IF NOT COMPLETED WITHIN 12 MONTHS
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�� � / Rough-in Inspection Required? ❑ Yes �] No Inspection Other Than Rough-In: � Ready Now ❑ Will Call
u� D�/ You must call the inspector when ready! Date Ready: � Q
I cert that I am th�CENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby est inspection of the electrical work at
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Own r xupant Na e Please Provide Two (2) Phone Numbers InGuding Area Code
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