P - 76101REQUEST FOR ELECTRICAL INSPECTION
1����- 0 4 3 7❑ Minnesota Board of Electricity � i
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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GENERALFEES
I POWER SUPPLIES
0 Ampere �, $25
8�1 Am ere $50
8Q0 Am re $75
FEEDERS
9 Ampere @ $5
200 Ampere @$10
IMMUNICATION, REMOTE CONTROL, SIGNALING
CfRCURS OF LESS THAN 50 VOLTS
Sysiem �evice or Apparatus @ $.50
ADDITIONS TO THE GENERAL FEES
ILY DWELLIPIGS PER UNI
I Unf� @ $50 Per Unft
uldi8ana{ Unit @ $25
OTHER ADDITIONAL FEES
ReVofit � $.25 �er Fixture
PivaE kri, ation Baom @ $40
�ued Home Park Lofs $25
�tlonal Vehicle Park Sites $5
�ta Bortdin In 'on $20
d InsnecUon (� $30 �r Hour
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Traffic Siqnal Standard
ONE $ TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Additional Ins ction Tri s $20
Irnestigative Fee
Reins 'on Fee @ $20
TOTAL FEE �O o �iQ
(minimum total fee is $20)
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I hereby certHy thffi I inspecled the electdcal insfalladon dascribed herein on the dat� steted:
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��� Rough-in Inspection Required? ❑Ye� g]No Inspec[ion OtherThan Rough-In: [�Ready Now ❑WIII Call
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You must call the inspector when ready! Date Ready:
t�r�fq tiiat I am the [� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at