P - 80484.,�133-996��F
Identity the work covered by this request:
❑NEW REMODEL ❑AD�ITION ❑REPAIR
GENERAL FEE
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am re � $75
CIRCUITS / FEEDERS
0 to 200 Am re �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CO
CIRCUITS, CIRCUITS OF LESS THAN 50
Each Svstem Device or Apparatus �
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL
lighting RetrotR � $25 per F'ature
Center Pivot Irtigation Boom � $40
Manufactured Home Park Lots � $25
Recreational Vehicle Park Sites � $5
Separate Bonding Inspection � $20
Soecial Insoectlon � $30 cer Hour
RE(�UEST 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 " '
P�,� ��.o��
Outdoor Li htin Standard � $1
Traffic Signal Standard � $5
, SIGNALING
i
�
FEES
Su lemental Fee � $20
Transformers up to 10 KVA �$70
Transfortners over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLIN�S, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Ins ion Tr' Each Dwellin Unit �$8(
Additional Inspection Trips � $20
Tlnvestiaative Fee
FOF
FOR OFFICE USE ONLY
� c�f��� ��ii� �tiii i�li� al��� �i�« ����i i�i�� ���� �R��
� 1 1 3 3 9 9 6 7�E
Request Date: Rough-in Inspection Required? Yes ❑ No Inspe
��� ��� r You must call the inspector when readyt Date
I certity that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER
total fee is
elecirical instaliation described herein on
-Ur
18M
�������
�
tion Other Than Rough-In: ❑ Reac
and hereby request inspection of the electrical work at