P - 76480REQUEST FOR ELECTRICAL INSPECTION -- ���
1����- 9 2 3 0� Minnesota Board of Electricity ,�-
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 ��,
(651)642-OSOOTTY/MRS 1-800-627-3529 w�vx�.electrieitv.slate.mn.us
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' ' GENERALFEES
SERVICES I POWER SUPPLIES
0 fo 400 Ampere $25
401 to 800 Am ere $50
Above 800 Am re $75
CfRCUITS I FEEDERS
0 to 200 Am re $5 .3 �r
Above 200 Am re $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIG
GIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus @$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNIT
3 to 12 Units @$50 Per Unit
Each ,Additional Unit @ $25
OTHER ADDITIONAL FEES
I.ighting ReVofit $25 per Fixture
Center Pivol Irri tion Boom @$40
Manufactured Home Park Lots $25
Racreational Vehicle Park Sites $5
rate Bondi Ins ction $20
Special Inspection (� $30 per Hour
tPtSTALLATION_MAY BE ORDERED
IIII � III � I� II �I II I� II IIi II Nl ll lll 8�l l��
1787923�
Outdoor
Supplemental Fee @ $20
Transformers up to 10 KV
Transformers over 10 KVi
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 @$80
Additional Ins ection Tri s $20
Investigative Fee
Reinspection Fee $20
TOTAL FEE ?{'a, �5,^
(minimum total fee is $20)
THIS AREA FOR INSPECTOR USE ONLY
I hereby certify that I inspected the electncal installation described herein on the dates stated:
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IIPLETED WITHIN 72 MONTHS
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� vaw: i Rough-in Inspection Required? ❑Yes %E]No I Inspection OtherThan Rough-In: [�Ready Now �Will Call
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� _ __ I You must call the inspector when ready!__ �ate Ready:_ _
I certify that I am the �'] LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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Owner/Occupant Name
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iPlease Provide Two (2) Phone Numbers Including
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. EleCtnc1al U61ity c I Electrical Utility Address �-
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� Contractor / Company Name �. Contractor License Number i Master E ian or
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t�nzed S' nature (Contractor or Owner Performing Installation) -- Please Provide Two (2) Phone Number
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