P - 75916REQUEST FOR ELECTRICAL INSPECTION
1-916-958 0 � '
Minnesota Board of Electric
1821 University Avenue Sufte 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 www.edectricity.state.mrx.us
Describe - ing the badc of the whfte co 'rf n�essaiy+- the work covered by Uvs requ �
�' GENERAL FEES Outdoor LigMing $1
SERVICES! POWER 3UPPLIES Traffic Signal Standard @$5
0 to 400 Am re @$25 Su Iemer�al Fee $ZO
401 to 800 Am re $50 Transfortners u to 10 KVA $10
Above 800 Am re$75 Transfortners over 10 KVA $�
CIRCURS / FEEDERS Transformer / Power Su I for S' / Outline LI hd $5
0 to 200 Am re $5 ONE B TWO FAMILY DVYELLINGS, EACH UNff
Above 200 Am re $10 Includes the Servfce and/or Power Supply up to 500 Amperes, All
ALARM, COMMUNICAT10N, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwel�ng Unft @$60
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Add(tlonal Ins on Tri $20
Each m Devic� or A s$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reins on Fee $20
MULTIFAMILY DWELLINGS ER UN TOTAL FEE �
3 to 72 untts (a� $50 Per Unit (minimum total fee is $20)
Each Add'Itlonal Unit @ $25 T1O'9A�"F0"6'�0R1��Y
OTHER ADDITIONAL FEES
Lightfig Retrofit @$.25 r Flxture I hmeby certHythat I inspected the electriml instellatlon desr�ed I�in an fhe datea sfated:
CeMer Pivot Irrigation Boom (a� $40 �1°' °' °ATE
ManufacWred Home Park Lots $25
Recreational Vehicte Park Sit� $5 `�AL0i�10N °A7E
Se e Bo Ins 'on $20 i� �Z.�
Speaal Ins on �$30 r Hour °�D1A�'ID01�0 °ATE
S ' Ir�sp�Uon (a� $.31 r Mile
THIS IN TION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12 MONTHS
FOR OfFiCE USE ONLY
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You must cell the U�apactor when readyt Date Ready.
I certity that I am tlie CENSED CONTRACTOR � COMPANY ❑ OWNER and hereby request inspedion of the electrical work at
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OMmerlOccupard Name Please Provide Two () Phorre umbers nclumrtg Area Code
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Conhactor / Campany Nmrre � Conhador License Number Masbsr EI 'cian or Power Limit� Technldan
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Autfm Signatu�e (Contractor or Oxmer rmirtg Ins(alladon) Please Provide Two (2) Phone Numbers I�Iuding Area Code
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