P - 79547REQUEST FOR ELECTRICAL INSPECTION
QQ% �a Minnesota 8oard of Electricity �
1 i� 2 4�.J .J 1 � � �s21 University Avenue Suite S-128, Saint Paul, Minnesota 55104
�� � (651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity.state. mn. us
Itlentify the work covered by this request: � ,/'/� �' �Y C �-� <�
1 l.: ��. a� V� i1 �_� ���— '� l� � �:
❑ NEW ❑ REMODEL ❑ADDITION REPAIR �
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am re C� $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.�
ADDITIONS TO THE GENERAL FEES
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIC
Lighting Retrofit � $25 per Fixtur�
Center Pivot Ircigation Boom � $4
Manufactured Home Park Lots �
Recreatlonal Vehicle Park Sites f�
Separate Bondirm Insoection � �:
Y
°1
Traffic Signal Standard � $5
Su demental Fee � $20
Transiormers u to 10 KVA 8$10
Transformers over 10 KVA � $20
Transformer / Power Su pl for Si ns / Outline Li hiin �$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Additional Inspection Trips � $20
InvestiQative Fee
FOR OFFICE USE ONLY
I Ill�!# I�III IIILI Ilfll lill� Ili�l Iltll 11��1 �III �III
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that 1 insoected the
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total fee is
I cerdfy that I am the�CICENSED COMRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the eiectrical work at: