P - 81929REQUEST FOR ELECTRICAL INSPECTION
1� O p J r O O.7 Minnesota Board of Electricity '`�
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
` (651) 642-0800 TTY/MRS 1-800-627-3529
www. e lectrici ry. state. mn. us
Identify the work covered by this request: +� a i /1 / J��'�
❑ NEW REMODEL ❑ ADDITION ❑ REPAIR
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GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traffic Siqnal Standard �$5 _
0 to 400 Ampere � $;
401 to 800 Amuere �
CIRCUITS I FEEDERS
0 to 200 Amcere �
RM, CAMMUN{CATfON, REMOTE CONTROL, SIGNALiNG
;UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus �$.50
3 to 12 Unfts �$50 P�
Each Additional Unit �
Center Pivot Irrigafwn Boom � $
Manufactured Home Park Lots �
� $.31 per Mile
,LATION MAY BE
Su lemental Fee � $20
Transformers u to 10 INA �$10
Transformers over 10 KVA C� $20
Transtormer / Power S for S' ns I Outline Li hG �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Ir�spection Trips Each DweIN Unit �$8�
Additional Inspection Trips � $20
Investiaative fee
USf ONLY
total fee is
electrical inslal�UOn desaibed
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FOR OFF�E USE ONLY
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Request Date: Rough-in InspecUon Required? ❑ Yes No Inspection Otlier Than Rough-In: ❑ Ready Now Witl CeN
You must call the inspector when ready! Date Ready:
I cerMy that 1 am ihe �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electricaF walc at: