P - 82482REG�UEST FOR ELECTRICAL INSPECTION
, �� � � � � � � Minnesota Board of Electricity
�+� � �� �- ig21 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� R�� � (651) 642-0800 TTY/MRS 1-500-627-3529
www. electricity. state. mn. us
Identify the work covered by this request: v��� ��,—��
W ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES TraHic Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee (� $20
407 to 800 Am ere (� $50 Transformers u to 10 KVA �$10
Above 800 Am ere �$75 Transfortners over 10 KVA �$20
CIRCUITS / FEEDERS Transfortner I Power Su I for Si I Outline Li ' �$5
0 to 200 Am ere �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$70 Includes the Service and/or Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwellin Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additlonal In ion Tri s�$20
Each S stem Device or ratus �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reinsoection Fee �$20
total fee is $20) 1:36 •
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Liahtina Retrofit � $25 cer Fixture
M2(IUfaClufed HOme Park Lots �" I hereby certify that I inspecled the eleciricel ir�stellalion described herein on the daies
Recreational Vehicle Park Site ` ` "�"'" `
Se rate Bondin Ins ion �$20
S ecial Ins ection �$30 r Hour /��
Soecial Insoectan �$.31 oer Mile � C �/
FOR OFFICE USE ONLY
I IIIIII I�lll I�I�t llllf lIIII lI�I III 1lll IlN
iE 1 O c 7 9 3 6 c� �4
I ceAify that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical worlc at