P - 79671REQUEST FOR ELECTRICAL INSPECTION
�,,, ����t - 9 0 2 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 "�'
IdentiTy the work covered by this request: ��/ _ �� p�'�
❑ NEW ❑ REMODEL ❑ ADDITION �I REPAIR / � �( J)� f v�°/�I. ' 1/.I i�Yl� 1�% %
0 to 400 Ampere � $25
401 to 800 Ampere � $50
Above 80(1 Ampere � $75
�UITS / FEEDERS
0 to 200 Ampere � $5
Above 200 Ampere � $10
RM, GOMMUNICATIQN, REMOTE CONTROI,
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus � 5.50
.TIFAMILY DWELLINGS (PER UNIn
3 to 12 Units (� $50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Lighting Retrofd � $25 per Fi�Rure
Center Pivot Irrigation Boom � $40
Manufactured Home Park Lots � $25
Recreational Vehicle Park Sites � $5
Sepa[ate Bonding I�spection � $2U
Soecial Insoection (� S30 oer Hour
Outdbor-Lichtin Standard � $i
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns ! Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelli� Unit �$8(
Additional Insoection Trios � $20
F'OR OFFICE USE ONLY
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that I
Fee �
total fee is
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herein on the dates stated:
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I certiiy that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at