P - 81892� � REQUEST FOR ELECTRICAL INSPECTION
1-�10 3� O�} 2 � q � Minnesota Board of Electricity �°�
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� ,� (651) 642-0800 TTY/MRS 1-800-627-3529
,�( `�.� n���p www.electricity.state.mn.us `' '
❑ NEW REMODEL pADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re �$25
401 to 800 Am ere �$50
Above 800 Am re � $75
CI UITS / FEEDERS
to 200 Am re � $5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIG
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
OTHER ADDITIONAL FEES
Hetroffi � $25 cer Fixture
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Traffic Si�nal Standard (� $5
Sup lemental Fee � $20 _
Transformers u to 10 KVA �$10
Transformers over 10 KVA @ $20
Transformer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$S(
Additional Inspection Trips � $20
Investiaative Fee
Recreational Vehicle Park SRes � $5 "`^"�""
Se arate Bondin Ins 'on � $20
S ecial In ction �$30 er Hour Fl""""�CfON
S ecial Ins ion �$.31 r Mile
THIS INSTALLATION MAY BE ORDEREQ DISCONNE
FOR OFFICE USE ONLY
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Request Date: Rough-in Inspection Required4 ❑ Yes No Inspec
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total fee is
tlie dates stated:
� �. —� � 1 You must call the inspector when readyl Date Ready: I
I certify that I am the [�ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: