P - 81641R ELECTRICAL INSPECTION
�°
Minnesota f Electricity °'�
� 1� O���� 8 8 ���,�. 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
, �' d. (651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
Identity the work covered by this request:
❑NEW ❑REMODEL ❑ADDITION �REPAIR
GENERAL F'E�3
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aretus �$.50
ADDITIONS TO THE GENERAL i
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit (� $25
OTHER ADDITIONAL FEES
Li htin Retrofd �$25 er Fixture
Center Pivot Irri ation Boom �$40
Manufactured Home Park Lots � $25
Recreational VehiGe Park Sftes �$5 C
Standard �
Transformers over 10 KVA � $20
Transtormer / Power Su I for Si ns I Outline Li htin �$5
ONE & TWO FAMILY DWELLtNGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
ING Circuits and Two Ins ection Trips Each Dwellin Unit �$8C
Additional Ins ection Tri s�$20
Investi ative Fee
� Reinsoection Fee � $20
total fee is
EGTOR USE OIRY
�rF*- F—iB-� �
I herebvi cerliN that I inspected tlie eieclriral instaAadon described herein on
FOR OFFlCE USE ONLY
i i���ii ����� ����i i���� i�i�i ����i ���ti ���a �ii� aor 50 ,
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Request te: Rough-in Inspection Required? ❑ Yes ❑ No Inspedion Olher Than Rough-Irr. Ready Now ❑ wll Call
� '� O You must call ttie inspector when readyl Date Ready:
I certi(y that I am the �LiCENSED CANTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspeclion of the efectric�l v�ak at: