P - 81714REQUEST FOR ELECTRICAL INSPECTION
1�IV 6�� 0 q. 7 �� E, 8121 U overs ty A eoue S tte'S 28, Saint Paul, Minnesota 55104
�;- (651) 642-0800 TTY/MRS 1-800-627-3529
, www.electricity.state.mn.us
Identiiy the work covered by this request: ��� � (� �.Z S� j,,, if
❑ NEW ❑ REMODEL �ADDITION ❑ REPAIR +J �
0 to 400 Ampere � $
401 to S00 Ampere �
Above 800 Ampere �
�UITS I FEEDERS
0 to 200 Am�ere � $
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
AbDITIONS TO THE GENERAL FEES
Each Additional Unit � $25
OTHER ADDITI01
Liphting Retrofit � $25 per Rxture
Center Pivot Irrigation Boom � $4(
Manufactured Home Park Lots � 9
n
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transformers up to 10 KVA (� $10
Transformers over 10 KVA � $20
Transformer I Power Supply for Signs / Outline Lighting �$5
— ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two insoection Trips Each Dwelling Unit �$81
� Reinspection Fee � $20
vQ,�.i,'1,�,'�' • 'S�
� ��o� �� a���
I herebv ce�tilv that I insoecled the elec
ipecial Inspection �$.31 per Mile I I ��
TNIC INCTAI I ATIAN MOV AF ARDERED DISCANNECTED IF f
m total fee is $20) �'�Q �
desaibed herein on the dates �tec
wh
wrE
� ��J �Q
I cerfrfy that I am the�ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: