P - 797841-242-748 :e9�
Itlentify the work covered by this request:
❑NEW REMODEL ❑ADDITION ❑
GENERAL FEES
SERVICES I POWER SUPPLIES
0 to 400 Am re �$25
401 to 800 Am ere �$50
Above 800 Amoere � $75
REQUEST FOR ELECTRICAL INSPECT�ON ,
Minnesota Board of Electriciry �°'
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us `' '
�Nr1i��n 'rc..n'l0 �°
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Apnaratus �$.50
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Center Pivot IrrigaGon Boom � $
Manufactured Home Park Lots �
Recreational Vehicle Park Sites �
C=7
Traffic Si nal Standard � $5
Su demenial Fee � $20
Transformers u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transformer / Power Su for Si ns / OutGne Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuifs and Two Inspection Tdps Each Dwelli Unit �$8l
Additional Insoection Trios � $20
1
Fee �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NUT COMPLETEO
FOR OFA� I�E ONLY
I fllliE lilll illlf 11111 IIIII 1111i iilll �Ili! Illf 111i ��6�
�E 1 2 4 c 7 4 8 O iE
Yes
total fee is
1
�1
L� �
a� -s-�
` O2 - ,--- - �- I
You must call the inspector when ready! Date Ready:
I certiTy that I am ihe LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby reqeest inspecbon of the elecfica! work at