P - 78288REQUEST FOR ELECTRICAL INSPECTION
� r Minnesota Board of Electricity
�- 0 3 2�� O� �82� University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-500-627-3529
www. electri ci ty. state. mn. us
IdeMify the work covered by this request:
EW ❑ REMODEL ❑ ADDITION ❑ REPAIR L✓ l� v i�-%�! �-�-
GENERAL FEES Outdoor ' Min Standard �$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am re �$25 Su lemental Fee �$20
401 to 800 Am re �$50 Transformers u to 10 KVA �$10
Above 800 Am ere �$75 Transformers over 10 KVA �$20
CIRCUITS / FEEDERS Transformer / Power Su I for Si ns / Outline Li htln (� $5
0 to 200 Am re �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re �$10 Includes the Service and/or Power Suppy up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwellinq Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIO
Li htin Retrofit �$.25 r Fixlure
Center Pivot Irri ation Boom �$40
Manufactured Home Park Lots � $25
Recreational Vehicle Park Sites � $5
Seuarate Bondina Insoection � $20
1 herebv cerWv that I
Fce �
total fee is
S ecial Ins ection �$.31 er Mile �"� - /Z %� — v 5 �
_ TNI_�N TS ALLATKlK�1AY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN_18 M HS '� �
FOR OFFICE USE ONLY
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Request D te: Rough-in Inspection Required? ❑ Yes No Inspection Other Than Rough-In: ❑ Ready Now ill Call
a� You must call the inspector when readyl Date Ready:
I cert'rfy that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecGon of the electrical work at:
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