P - 81748REQUEST FOR ELECTRICAL INSPECTION
%(� Minnesota Board of Electricity ��
�!' 0 61 � 1 J 0 g� s 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-OS00 TTY/MRS 1-500-627-3529
,- www. electricity. state. mn. us
Identify the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION EPAIR �
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
'401 to S00 Am ere � $50
Above S00 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
I Home Park Lots �
Vehicle Park Sites �
Mile
THIS
Traffic Si nal Standard � $5
Su Iementai Fee � $20
Transformers u to 10 KVA �$10
Trensformers over 10 KVA � $20
Transiormer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Iricludes the Service arM/or Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit (� $8(
Addiiional Inspection Trips � $20
Investiaative Fee
FOR OFFICE USE ONLY
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total fee is
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WITHIN 18 MONT� ___
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I certi(y that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at