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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: