P - 76528REQUEST FOR �LECT@ICAL INSPECTION
1 3 4 7 514 Minnesota Board of lectricity
� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651)642-0800 TTY/MRS 1-500-627-3529 - _
www.electricity.state.mn.us
IIdentify the work covered by this request:
�NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
401 to 800 Am ere �$50 `
Above 800 Am ere (� $75
CIRCUITS / FEEDERS
0 to 200 A re�$5 �
Above 200 Am re � $
ALARM, COMMUNICATION, REMOTE CONTROL, SIG
CIRCUITS; GIRCUITS OF LESS THAN 50 VOLTS
Each S em Device or A ratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Li htin Retrofit �$25 r Fixture
Center Pivot I' tion Boom �$40
Manufactured Home Park Lots � $25
Recreational Vehicle Park Sites � $5
Se arate Bondin Ins 'on (� $20
S'al Ins ion d$30 r Hour
S ial I ' �$.31 r Mile
Outdoor Li htin Standard � $1
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transfortners u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortner / Power Su I for Si ns / Outline Li htin (� $5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Additional Ins ection Tri s�$20
Investiqative Fee _ �
Reinsoection Fee � S20 � �
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total fee is $20) b/.
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_ THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN jIMONTHS
FOR OFFlCE USE ONLY ��2-65
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Olher Than Rough-In: ❑ Ra�dy Now ❑ Will Call
You must rall the inspector when ready! Date Feady: �
I ceAiiy that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electricai work at: