P - 81891REQUEST FOR ELECTRICAL INSPECTION
�� e? Minnesota Board of Electricity —
1����� Q�� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
U (651) 642-0800 TTY/MRS 1-500-627-3529
www.electricity.state.mn.us '' '
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Identify the work cavered by this request:
❑ NEW ❑ REMODEL ❑ADDITION ❑ REPAIR � � � �
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES I POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am re �$50 Transformers u to 10 KVA �$10
Above 800 Am re �$75 Transfortners over 10 KVA �$20
CIRCUITS / FEEDERS Transformer / Power Su I for Si ns / Outline Li htin �$5
0 to 200 Am re �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re �$10 Includes the Service andlor Power Suppty up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelli Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additbnal Ins ion Tri s�$20
Each S tem Device or ratus �$.50 Investl tive Fee
ADDITIONS TO THE GENERAL FEES Reins ection Fee �$20
MULTIFAMILY DWELLINGS PER UNI TOTAL FEE
3 to 12 Units �$50 Per Unit (minimum total fee is $20) ��
Each Additi0nal Unit �$25 f-0H INSPECTOfl USE ONLV
OTHER ADDITIONAL FEES
Li htin Retrofit �$25 r Fixlure
Center Pivot I' ation Boom �$40
Manufactured Home Park Lots �$25 I he certiy mat I inspected tl,e e�earical i�6on described hereir+ on rie � s�d:
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Recreational Vehicle Park Sites � $5
Se arate Bondin In ion �$20
S ial Ins eclion �$30 r Hour `w'`�PE0i0N ��_ ��
S ial In 'on � $.31 Mile �� ���
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
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RequeiDat� Rough-in Inspection Required? ❑ Yes o Inspection Other Than Rough-In: Ready Now � wll Cali
You must call the inspector when ready! Date Ready:
I certify that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at
Job ress (Street Box� or Route No.j City Zip Code
Section Township Range Fre No. County
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