P - 798331-��14-583 �:
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Identiiy the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION REP/
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25 �
401 to S00 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus � 5.50
OTHER ADDITIONAL FEES
Manufactured Home Park Lots (� $
Recreatlonal VehiGe Park Sites � ;
Separate Bonding Inspection � E2l
Soecial InsoecGon � �30 oer Fbur
REQUEST 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
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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 / Outiine Li htin �$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8C
Additional Inscection Trios � $20
5 INSTALLATION MAY BE ORDERED DISCONNECTI
FOR OFFlCE USE ONLY
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IF
total fee is
the electrical installation described herein an the dates st�ed:
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THS
I certity that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecGon of the electrical virork at: