P - 80154REQUEST FOR ELECTRICAL INSPECTION
.� � � � � � � °� �, , Minnesota Board of Electricity
� � e�° �e 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
'� � �`> � (651) 642-0800 TTY/M RS 1-500-627-35�9�� � �
www. electri ci ry. state. mn. us
❑ NEW REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 40� Amoere � $25
Above 800 Am ere � $75
IRCUITS / FEEDERS
0 to 200 Am ere (� $5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CO
CIRCUITS, CIRCUITS OF LESS THAN 50
Each S stem Device or A aratus (�
ADDITIONS TO THE GE�
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each A�itional Unit � $25
Manufactured Home Park Lots �
Recreational Vehicle Park Sites �
Seoarate Bondina Insoection � $;
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Outdoor Lighting Standard � $1
TraTfic Signal Standard � $5
Supplemental Fee � $20
Transfortners uo to 10 KVA �$10
Transformer / Power Su I for S' ns / Outline Li hd �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Senrice and/or Power Suppty up to 500 Amperes, All
SIGNALiNG Circu'ds and Two Inspection Trips Each Dwelli UnR �$8f
Additional Ins ection Tri � $20
Investiaative Fee
H/1-'�-��
total fee is
herein an me da�s s�ed:
Special Inspection �$.31 per Mile 7�°� �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFICE USE ONLY
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Request Date: Rough-in tnspection Required? ❑ Yes No Inspec[ion Other Than Rough-In: ❑ Ready Now Witi CaYI
��� You must call the inspector when readyl Date Ready: � �
I cer�ty that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: