P - 78771� REQUEST GJR ELE.CTRICAL INSPECTION
1 3 4 7 3 2�„ � Minnesota Board of �lectriciry.
� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electrici ty. state. mn. us
Identity the work covered by this request:
❑ NEW �iEMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �
401 to 800 Am re �$50
Above 800 Am re � $75
CIRCUITS / FEEDERS
0 to 200 Am ere ��S
Above 200 Amoere � $10
RM, COMMUNICATION, REMOTE CONTROL, SIGNALING
;UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
Each A�itional Unit � $25
OTHER ADDITIONAL
Lighting Retrofit � $25 per Flxlure
Center Pivot Irriaation 800m � $40
� f 1 k..�
Outdoor Li htin Standard � $1
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA (� $10
Transformers over 10 KVA � $20
Transformer / Power Su for Si ns / Outline ' htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service aruilor Power Suppry up to 500 Amperes, !UI
Circuits and Two Inspeclion Trips Each Dwellin Unit �$8(
Additional Ins 'on T' � $20
Investi tive Fee
Reinsoection Fee � $20
(minimum total fee is $20) .�
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Manufactured Home Park Lots �$25 1 hereby ce � that I�speCtedtl� eledric�installatiardacriued nerem on me aares s�area:
Recreational Vehide Park Sites � $5 "a"'"'" °�'�
rate Bondin Ins � S20 G-.—��.� • - lra 3
S ial In 'on �$30 r Hour """` "�`�"0N �'�
S ial In ' n�$.31 r Mile �_ Z� w
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
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FOR OFFICE I�E ONLY �� �
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspectian Other Than Rough-In: ❑ Ready Now ❑ Will Cail
You must call the inspedor when ready! Date Ready: `
I certi(y that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the elecVical vuark at