P - 76878REQUEST FOR ELECTRICAL INSPECTION �$
1��� e�, 2 9 1 � Minnesota Board of Electricity �
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 ��
(651) 642-0800 TTYIMRS 1-800-627-3529 www.electricrty.state.mn.us ��t�
Describe usi�he back o��whi� co ' ne� - the wo � this request: �� � � S � �
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GENERAL FEES Outdoor Lighting Standard $1
SERVICES / POWER SUPPL�ES Traffic Signal Standard $5
0 to 400 Am ere $25 Su plemental Fee $20
401 to 800 Am re $50 Transfortners u to 10 KVA $10
Above 800 Am re $75 Transformers over 10 KVA $ 20
CI S I FEEDERS Transformer / Power Su I for Si ns / Outline Li htin $5
0 to 200 Am ere $5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re $10 Includes the Service and/or Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CANTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelling Unit @$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Ap aratus $.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNIT
3 ta 12 Units @$50 Per Unit
Each Additional Unit @ $25
OTHER ADDITIONAL FEES
Liqhfinq Retrofit (� $25 cer Fixture
Park Lots I
Park Sites
Fee
total fee is
I inspeded the elecVipl installation described
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spection $.31 per Mile �
ALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12 MONTHS
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18202911 �G,��;
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"�"c Rough-in Inspection Required? ❑ Yes
j �� �� You must call the inspector when ready!
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I certify that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY
Job Site Street Address
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Owr�ccupant Name
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Electrical Utilitv
Inspedion Other Than Rough-In: � Ready Now � Will Call
�te Ready:
t�OWNER and hereby request inspection of the electrical work at
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. Fire No. Count
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iease Provide Two (2) Phone Numbers Including Area Code
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License Number Master Electrician or Power LimRed �
License Number
Please Provide Two (2) Phone Numbers Including Area
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