P - 78727REQUEST FOR ELECTRICAL INSPECTION
� 1 3 4 7 3 0 5 Minnesota Board of Electricity
� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 l?Y/MRS 1-800-6273529 -
www.electriciry.state.r/an.us _„ �
work covered by this reqaest:
O REMODEL ❑ ADDITION ❑ REPAIR
0 to 400 Ampere �$25 �O O �
401 to 800 Ampere � $50
Above 800 Ampere � $75
�UITS / FEEDERS
0 to 200 Ampere � $5
Above 200 Ampere � $10
RM, COMMUNICATION, REMOTE CONTROL,
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL i
.TIFAMILY DWELLINGS (PER UNI�
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Liqhting Retrofit � $25 per Fature
Center Pivot Irri tion Boom �$40
Manufactured Home Park Lots � $25
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Traffic Si nal Standard � $5
Su demenlal Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su for S' ns / Outline ' 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 �$8C
Additional Insoection Trips � $20
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Fee
tok�l fee IS
stated:
S ial Ins 'on �$30 r Hour "'�'""' 7�r'_ _�.�� I
Soecial Inspection �$ 31 per Mile �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFlCE I�E ONLY
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Request D te: Hough-in Inspection Required? es ❑ No Inspection Other Than Rough-In: ❑ Ready Now ill Call
�� d 3 You must call the inspector when ready! Date Ready:
I certiTy that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY �:DWNER and hereby request inspection of tl�e electr�al wak ffi:
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