P - 81881REQUEST FOR ELECTRICAL INSPECTION
"'r � � ; Minnesota Board of Electricity �°=
J.. � 0 91 � V�� ;�� 182� University Avenue Suite S-12$ Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
IdentiTy the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADOITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re �$25
401 to 800 Amoere � $50
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere (� $10
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Anoaratus �$.50
Each Additional Unit � $
OTHER
� n n ti
Outdoor Li htin Standard � $t -
Traific Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortner / Power Su for Si ns / Outline ' htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Ins ction Tri s Each Dwelli Unit �$8(
Additional Insoection Trios � $20
��
Fee �
total fee is
Manufactured Home Park Lots �$25 I hereby certlfy that I inspected the eledrical inslallation described herein on tlre oetes starea:
Recreatlonal Vehicle Park Sites �$5 ' fl01GH1N DA7E
Se rate Bondin Ins 'on � $20
S'al In ion �$30 r Hour '� "�''�tOM °"'E
Soecial Insoecction (� $.31 oer Mile `'"' "���
FOR OFFACE IIBE ONLY
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Request Date: Rough-in Inspection Required? es Inspection Other Than Rough-In: eady Now � Will Call
� O You must call the iiuupector when ready! Date Ready: �
I certify that I am the [�LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: