P - 819481-�125-140 q�
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Identity the work covered by this request:
W ❑ REMODEL ❑ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
� to 40U A re �$25
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am re (� $5
Above 200 Am ere � $10
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity �"°�
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-OS00 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or ratus �$.5U
ADDITIONS TO THE GENERAL FEES
Retrofit � $25 oer Fixture
Recreational Vehide Pa�k Sites
Seoarate Bondina insoection �
Outdoor Liphting Standard � $1
Traffic Si nal Standard � $5
Su emental Fee � $20
Transformers u to 10 KVA �$70
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 andlor Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$8(
Additional Inspection Trips � $20
Investigative Fee _
� Reinsoection Fee � $20
total fee is
I herebvi certiNN fhat I inspected the eledrical installaUon desaibed herein a� tlie
�
THIS INSTOLLATION MAY 6E ORDERED DISCONNECTED IF1M9��0!
I ceriify that I am the ]�{ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the elactrical wodc ah
EB-00001A-13 7/7/'1000 � � BOApD OF ELECTRICT/ COPY MS7AUCTpNB ON BACK OF YELLOW COPY