P - 80437, REQUEST FOR ELECTRICAL INSPECTION
1 O�� 2 5 5 �� Minnesota Board of Electricity
� � ¢� . i821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
�" �a (651) 642-0800 TTY/MRS 1-500-627-3529
www.electricity.state.mn.us
Identify the work covered by this request:
❑NEW REMODEL ❑ADDITION ❑REPAIR
GENERAL FEES
SERVICES 1 POWER SUPPLlES
/ 0 to 4� Am ere �$25 d�
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUfTS OF LESS 7HAN 50 VOLTS
Each S stem Device or aratus �$.50
ADDITIONS TO THE GENERAL F
MULTIFAMILY DWELLINGS PER UN!
3 to 12 Uniis �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Liahtino Retrofit � $25 oer Fixture
Tratfic Si nai Standard � $5
Su lemental Fee (� $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns I Outline Li hiin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the SeNice andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$80
Additional Ins ection Trips � $20
Investi ative Fee
Reinsoection Fee � $20
total fee is
descnbed herein
-- ----- --- -- -- -
Separate Bonding tnspection � $20 (] ►�r , , 6 / �.. d /
S ial Inspection � $30 per Hour ��T� �'"�"�`�10N � •_ — . ["j, _ x.,� j-��
Special Inspection �$ 31 per Mile �� F" // I
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFlCE USE ONLY
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t certify that I am the �LICEMSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecUOn of the electrical work at:
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BOAND OF ELECTRICRY CO W IN37AUCT10� �N 9ACK OF YELLOW COP1I