P - 75989REQUEST FOR ELECTRICAL INSPECTION �" '
1����� Q, 2� � Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-600-627-3529 www.electricity.sdate.mn.us
Descnbe -usin9 th_ e badc o�h, e white coPY if ��ssary - th wo / red �y� �.
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GENERAL FEES Outdoor Lighting Standard $1
SERVICES I POWER SUPPLIES Traffic Signal Siandard @$5
0 to 400 Ampere @$25 Sup lerrtental Fee @$20
401 to 800 Am re $50 Transfortners u to 10 KVA $10
Above 800 Amoere l�D �75 Transformers over 10 KVA na $ 20
Includes the Service and/or Pawer Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each DwelMg Unit @�0
CIRCUITS OF LESS THAN 50 VOLTS
iystem Device or Apparatus @ $.50
ADDITIONS TO THE GENERAL FEES
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Home Park Lats
INSTALLATION RAAY BE ORDERED �
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ReinspecUon Fee @ $20
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(minimum total fee is
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�� Rough-in Inspection RequfredT ❑Yes ❑ No Inapedion OtherThan Rough-In: ❑ Ready Now �Wip Call
�� �_ � j�' You must cell the inspector when readyl Date Ready:
I certify that I am the 0 LICENSED CONTRACTOR ❑ COMPANY 0 OWNER and hereby request inspection of el�l work at
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