P - 81847� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
'� �-37 'rj-4O7 '� 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn. us
Identify the work covered by this request:
�MIEW ❑ REMODEL ❑ ADDITION ❑ REPAIR XCEL EhIERGY �AVER'� SVItITCH
GENERAL FEES Outdoor Liahtina Standard �$1
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNIT
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Li htin RetrofR �$25 er FiMUre
Center Pivot Irri 'on Boom � $40
Manufactured Home Park Lots � $25
Recreational Vehicle Park SNes � $5
S rate Bondin In tion �$20
S ial Ins ion �$30 r Hour
Special Inspec6on � $.31 per Mile
to 10 KVA
ONE & NVO FAMILY DWELLiNGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$E
Additional insqection Trips � $20
� Reinspection Fee � $20
(minimi
FOP INSPECTOP USE ONLY
I hereby certify thet I inspectetl Me elec[rical installation
ROUGH IN
fn�u xasaECTroH ��
��
�.)�.
TOTAL FEE
total fee is S20)
ere�n on me ae�es smrea:
DATE
�' �
FOR OFFICE USE ONLY
I I II III IHII I{III IIIiI IIII{ IIIII II� � 1�{
�� �l �� �
ao,�
" 1 3 7 5 4 0 7 2*
Request Date: Rough-in Inspection Required7 ❑ Yes ❑ Inspection Other Than Rough-in: eady Now ❑ Will Call
You must call the inspector when readyl Date Ready:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: