P - 81832REQUEST FOR ELECTRICAL INSPECTION
' ° Minnesota Board of Electricity
1�`i I��� 6 3 2 ��; 182� University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 TfY/MRS 1-800-627-3529
www.electricity.state.mn.us " '
Identity the work covered by this request: �(��— ��� `t ,., _ � (.
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❑ NEW ❑ REMODEL ❑ ADDITION REPAIR
GENERAL FEES Outdoor Liqhting Standard �$t
0 to 400 Am ere �$25
401 to 800 Ampere � $50
Above 800 Ampere � $75
�UITS / FEEDERS
0 to 200 Ampere � $5
Above 200 Ampere � $10
RM, COMMUNICATION, REMOTE CONTROL, SIGNALING
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
.TIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unft
Each Additlonal Unit � $25
OTHER ADDITIONAL FEES
Li htin RetroM �$.25 er Fixture
Center Pivot Irrigatan Boom � $40
Manufactured Home Park Lots � S25
� $20 — " ■ .
TraBic Si nal Standard (� $5
Su iemental Fee � $20
Transformers u to 10 KVA �$10
Transiormers over 10 KVA � $20
Transformer / Power Su i for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 5� Amperes, PJI
Circufts and Two Inspection Trips Each Dwellin Unit �$8C
Additional Insoection Trios � $20
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total fee is
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THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF N�T COMPLETED WITNIN 78 M_ONTFiS,�__
FOR OFFICE USE ONLY
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R� Date: �, Rough-in Inspection Required? ❑ Yes No Inspeclion Other Than Rough-In: dy Now � WIII Call
You must call the inspector when readyl Date Ready:
i certify that i am the�CICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at