P - 761071 7 8 7 0 6 4� 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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GENERAL FEES Outdoor Lighting Standard @$1
SERVICES / POWER SUPPLIES Traffic Signal Standard @$5
0 to 400 Ampere $25 Supplemental Fee @$20
4D1 to 860 Am re $50 Transformers u to 10 KVA $10
Abqve &00 dmpere (� $75 Transfortners over 10 KVA C� $ 20
2W Am re $10 - Includes the Service and/or Power Supply up to 500 Amperes, All
Nv1QAUNICATION, REMOTE CANTROL, SIGNALING CircuiLs and Two Inspection Trips Each Dwelling Unit @$80
CIRCUITS OF LESS THAN 50 VOLTS Additional Ins 'on Tri @$20
iystem DeNce or Apparatus @$.50 Investigative Fee
ADDITIONS TO THE GENERAL FEES Reins ction Fee @$20
ILY DWELLINGS PER UNI TOTAL FEE `(jo„(}
! Units @ S5o Per unit (minimum total fee is $20)
lddiiti�onal Unft @$25 THSaa�n FoR �croR use or�v
OTHER ADDITIONAL FEES
Retrofit @$25 r Fixture I hereby certify that I inspected the electrical Instella6on d�cribed herein an the de0es stated:
Pivot Irrigation Boom (N $40 RWGH M on,�
� lNSTALLATION MAY BE
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IF NOT COMPLETED
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You must call the inspector when ready! Date Ready:
I c�iy that I am the ['�j LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at
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