P - 79631REQUEST FOR ELECTRICAL INSPECTION
: � Minnesota Board of Electricity "�
<� �� 8���� 6 �� m 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
e��° (651) 642-0800 TTY/MRS 1-800-627-3529
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www.electricttv.state.mn.us,
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❑ NEW REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
400 Amoere C� $25 / DC�
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Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus �$.50
Each Add'Rional Unit � $25
OTHER ADDITIONAL FEES
Manufactured Home Park Lots � g
Recreational Vehicle Park Sites �
Separate Bonding Inspection � $21
Special Inspection � $30 per Hour
Special Inspection � $.31 per Mile
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Traffic Si nal Standard � $5
Sup lemental Fee (� $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li htin (� $5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Additional Inspection Trips � $20
Investiaative Fee
FOR OFFICE USE ONLY
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TOTAL FEE Q
(minimum total fee is $20) U� �`
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d I inspected the electrical insfallation described herein on ihe dates siated:
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Request Date: Rough-in Inspedion Required? �S'es ❑ No Inspection Other Than Rough-In: ❑ Ready Now �J riin Gan
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�r p� ��Q � You must call the inspector when ready! Date Ready: �
I certiiy that I am the�LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection ot ihe electriGal work at
EB-OOOOtA-13 7/1/2000 BOARD OF ELECTRICITY COPY �mf�r7uc:�nma wa ew�n �r reu.vn �.vrr