P - 817681-0�7-418 $sm �il
IdentiTy the wark covered by this request:
A NEW ❑ REMODEL ❑ADDITION ❑ REPAIR
0 to 400 Am ere �
401 to 800 Am ere
Above 800 Ampere
CIRCUITS / FEEDERS
0 to 200 Amoere �
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus �$.50
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
�/�//
Traffic Si nal Standard � $5
Su lemental Fee (� $20
Transtormers u to 10 KVA �$10
Transformers over 10 KVA (� $20
Transformer / Power Su I ior Si ns ! Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$8(
Additional Insoection Trios � $20
Fee �
Each Addftional Unit � $25 '"'""'"'" "" """
OTHER ADDITIONAL FEES
Li9htin• RetroM � $25 er Fixture
Center Pivot Irri ation Boom �$40
Manufactured Home Park Lots �$25 I here cenity �hat I i�s
Recrea6onal Vehicle Park Sites 1010H1N
Se arate Bondin In 'on �
S ectial Ins ection �$30 r Hour `�'""�'
S'al I ection �$.31 r Mile
THIS INSTALLATION MAY BE �RDERED DISCONNECTED IF I
total fee is $20�W
described herein on the detes stated:
�?
I certiiy that I am the ❑ LICENSED CONTAACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: