P - 82013REQUEST FOR ELECTRICAL INSPECTION
1. 12 5 9 2 6� Minnesota Board of Electricity
� � 1821 University Avenue Suite S-128, Saint Pauf, Minnesota 55iO4
'��� (651) 642-0800 TTYIMRS 1-800-627-35�9
� �. �//� S www.electriczty.state.mn.us
❑NEW �OT�EMODEL ,DADDiTION ❑REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
� to 400 Am ere �$25
401 to 800 Am re �$50
Above 800 Am re � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Amoere f� $10
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50 ^
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNITI
Lighting Retrofit � $25 per fixture
Center Pivot Irrigation Boom � $4C
Manu(actured Home Park Lots � $
Recreational Vehicle Park Sites � '
Traffic Si nal S n d�$5
Su lemental (� $20
Transformers u to 10 KVA �$10
Transformers over 70 KVA � $20
Transformer I Power Su I for Si ns ! Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNI7
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two inspection Trips Each Dwelling Unit �$8C
Fee �
total fee is
2897L.�
____ THI$ INSTALL.ATION_MAY_BE ORDERED DISCONNECTED IF R6T COMPLEiED WIl
FOR OFFICE USE ONLY � � �
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/ ( You must call the inspeetor when raady! Date Ready:
I certi that 1 am the LICENSED CANTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: