P - 797551-371-599 ��e
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REC�UEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity.state. mn. us �'
IdentiTy the work covered by this request: ���� ��� � ��
❑ NEW EMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES
0 to 400 Am re �$25
401 to 800 Am re �$50
Above S00 Am re (� $75
CIRCUITS I FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S em Device or aratus �$.50
ADDITIONS TO THE GENERAL FEES
Lighting Retrofit � $25 per Fixture
Center Pivot Irtigation Boom � $40
Manufactured Home Park Lots � $25
Recreational Vehicle Park Sites � $5
Separate Bonding Inspection �$20 f j n
Special Inspection � $30 per Hour
Special InspecGon � $.31 per Mile
� ' .r� -
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Traffic Si nal Standard � $5
Su plemental Fee � $20
Transiormers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer I Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Suppty up to 500 Amperes, All
Circufts and Two Inspection Trips Each Dwelling Unit �$8C
Addftional Inspection Trips � $20
Investiaative Fee
that
TH151NSTALLATION MAY BE ORDERED DISCUNNECTED_IF I
— _ _
FOR OFRCE U8E ONLY
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Reque�atj: 3 a� iiough-in Inspection Required? ❑ Yes o Inspecti
IYou must call the inspector when readyl Date R�
I cerGiy that I am the �CENSED CONTRACTOR ❑ COMPANY ❑ OWNER
total fee is
installation described herein on fhe dates
. 16 _C,
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a�.so
Rouah-In: eadv Now ❑ Will Call
and hereby request inspection of ihe electrical work at: