P - 82497REQUEST FOR ELECTRICAL INSPECTION
1 � � � � � � ` � 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 lectriciry. state. mn. us
Identity the work covered by this request:
❑ NEW ❑ REMODEL ADDITION ❑ REPAIR � �l r� ��'�` `� �Ser �
GENERAL FEES Outdoor Li htin Standard C� $i
SERVICES I POWER SUPPLIES Traffic Si nai Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am re �$50 Transformers u to 10 KVA �$10
Above 800 Amuere (� $75 Transformers over 70 KVA �$20
Above 200 Am ere � $10
pLARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or ratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Urtit � $25
Lighting Retrofit � $25 per �'udure
Center Pivot Irriga6on Boom � $4a
Manufactured Home Park Lots � $
� $.31 per Mile
� Transfortner / Power Suppty for Signs / Outline Ughting �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, PJI
CircuiGs and Two tnspection Trips Each Dwelli Unit �$8C
Additional Inspection Trips � $20
total fee is
that I insoecled ttie electrical installation descAbed herein on Ihe
THIS IN$TALLATION MAY BE ORDERED DI$CONNE�TED
wn o�ce use a+�r
'IIIIIIIIIIIIIIIIIIIIIIIII�III�II�II�INIIII �����
� 1 D 3 7 9 3 3 7�E [e'�'�p��?,S�
��
��G �
18. MQMTH�—.
Now
I/O �' $"D � I You must call the inspector when readyl I Date Ready: I I
I certily that I am ihe �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER arni hereby request inspection of the elecVical work at