P - 795511-171-292 ���R�
:ntify the work covered hy this request:
1
�IEW ❑REMODEL ❑ADDITION ❑REPAIR
GENERAL FEES
!RVICES / POWER SUPPLIES
to 400 Amoere � $25 � d
Above 800 Am ere (�
CIRCUITS / FEEDERS
.. 0 to 200 Amcere � S
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity �
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us '� '
'ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A ratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit -
i�. ���
Traffic Signal Standard � $5
Supplemental Fee � $20
Transtormers up to 10 KVA �
Transformers over 10 KVA �
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 �$8L
AddiGonal Inspection Trips � $20
Investiaative Fee
OTHER ADDITIONAL FEES ��
�.ghGn• Retrofit � $25 er Fature
Center Pivot Irri ation Boom �$40
Manufactured Home Park Lots �$25 I hereby ce' thffi I inspeded fhe
Recreational Vehicle Park Sites �$5 �N IN
Se arate Bondin Ins 'on � $20 -
S ial Ins ion �$30 r Hour �'""�10N
S ial Ins �on �$.31 er Mi�
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF N C
FOR OFFICE USE ONLY
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m total fee is $20) ��
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described he�ein on tNe dates sta6ed
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nequesr uare: Hougn-in Inspection Required? �V I Yes ❑ No Inspection Other Than Rough-In: ❑ Ready N' Will Call
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`"/ �,! CT You must call the inspector when ready! Date Ready:
I certify thai I am the �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical wwk at: