P - 79855REQUEST FOR ELECTRICAL INSPECTION
�% e� Minnesota Board of Electricity �`°"
1!�O L�- 6 5 2 �, � 1821 University Avenue Suite 5-128, Saint Paul, Min�esota 551o4
, �a (651) 642-0800 TTY/MRS 1-800-627-3529
� www.electricity.state.mn.us ,., _
IdentiTy the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re �$25 �?
401 to S00 Am ere �$50
Above 800 Am ere � $75
CIRCUITS � FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus � 5.50
.TIFAMILY DWELLINGS (PER UNI�
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Manufactured Home Park Lots � $
Recreational Vehicle Park Sites �
Separate Bonding Inspection � $21
Special Inspection � $30 per Hour
Soedal Insoection � $.31 oer Mile
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Outdoor Li hti 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 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 �$80
Addftional Inspection Trips (� $20
Investiaative Fee
FOR OFFlCE USE ONLY
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(minimum total fee is $20 dr`
= ONLY
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that I i ed tlre electrical insNaNation descr�ed Irerein on the dates slated:
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7 y ..Gz
D IF NOT COMPLETED WITHIN 18 MONTHS
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I certi(y that I am the j�LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and he�eby request inspeclion of the electrical work at: