P - 77608REQUEST FOR ELECTRICAL INSPECTION ° ��
� � $ � 8 � 8 � 4 �'"�� Minnesota Board of Electricity �-, �
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 �
f- �� ��$ � (651)642-0800TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
Describe -usin the back of the white y'rf necessary - the work covered by this r uest: ���� ���
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GENERAL FEES Outdoor Li htin Standard $1
SERVICES / POWER SUPPLIES Traffic Si nal Standard $5
0 to 400 Am re$25 Supplemental Fee $20
401 to 800 Am re $50 Transformers u to 10 KVA $10
Above 800 Ampere (�a, $75 Transformers over 10 KVA (� � 20
Above 200 Am ere $1U '
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCU�TS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or aratus $.50
ADDITIONS TO THE GENERAL FEES
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Fee
Fee
3 to 12 Units @ g50 Per Unit (minimum total fee is $20) O( v`-
EaCh Additi0�el Unit @ $25 THISAREAFORINSPECTORUSEONLY
OTHER ADDITIONAL FEES
Lightln Retrofit $.25 per Fi�ure I hereby certify that I inspected Ne electrical installa6on desaibed herein on ihe dates stated:
Center Pivot Irrigation Boom $40 R01G"""
Manufactured Home Park Lots $25
Recreational Vehicle Park Sites $5 P1W1'"��T'0N
Se rate Bondin Ins ion $20 �
S iallns ion $30perHour ExPrc�o�naerma+eo
S ial Ins ion $.31 per Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12
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Date: � Rou h-in Ins dion R uired? ❑Yes . No Ins
� g pe eq pection Other Than Rough-In: � Ready Now Will Call
�� Q�.� v You must call the inspector when ready! Date Ready:
I certify that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at