P - 82484REQUEST FOR ELECTRICAL INSPECTION
%7 Minnesota Board of Electricity
1��i1�21 �� I 1 m, ° 182� University Avenue Suite S-128, Saint Paul, Minnesota 55104
� � (651) 642-OS00 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
Identify the work covered by this request:
❑ NEW ❑ REMODEL DDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am re � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
EacN Svstem Device or Aooaratus �$.50
3 to 12 Units �$50 Per Unft
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Liahtina Retrofit � $25 oer Flxture
nspection � $20
� $3o per Hou�
� $.31 per Mile
,LATION MAY
Outdoor Li htin Standard � $1
Tra�c Si nal Standard � $5
Su lemental Fee � $20
Transfortners u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transformer / Power Su tor Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, AN
Circuits and Two Inspection Trips Each Dwellin Unit �$80
Addftbnal Inspection Trips � $20
�Investiaafive Fee
total fee is
that I inspected the ek�ctrical i�fallation described herein on the dat� slated:
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FOR OFFICE USE ONIY
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Requ ffie: Rough-in Inspection Required? Yes ❑ No Inspection Other Than Rough-In: ❑ Ready Now ❑ WIII Ca0
� L L �� You must call the inspector when dyl Date Ready: �
I certify that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspeclion of the elechic�al work at:
Job Addre S x, or Ro No.) ♦ �' .� C' Z Code
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E8- tA-73� 7/1/2000 � � � BOMD OF ELECTAICRY COPY qiBTHUCTON3 ON BACK OF YELLOW COPY