P - 781741�"=576-324 �6
0 NEW ❑ REMODEL ❑ ADDITION �
�,�,e. � 3 gaa8
GENERALFEES
SERVICES I POWER SUPPLIES
0 to 400 Am ere $25
401 to 800 Am ere $50
Above 800 Amcere C� S75
ALARM, COMMUNICATION, REMOTE CONTROL
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus $.50
ADDITIONS TO THE GENERAL I
MULTIFAMILY DWELLINGS PER UNIT
3 to 12 UniGs @$50 Per Unit
Each Additional Unit (� $25
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Sairrt Paul, Minnesota 55104
(651)642-0800TTY/MRS1-800-627-3529 www.electriciry.state.mn.us
2 Describe -using the back of the white copy if necessary - the work covered by this request:
�nter Pivot Irtiga6on Boom �il $40
�nufactured Home Park Lots $25
crea6onal Vehicle Park Sites
� arate Bondin Ins tion
�ecial Ins 6on $30 r Hour
�ecial Ins tion $.31 r Mik
INSTALLATION MAY BE ORDERED
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Traffic Signal Standard
Suoolemental Fee � S
�ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppiy up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
TOTAL FEE I Q� O�
(minimum total fee is $20)
iH15 AREA Fqi INSPECTpt lISE ONr
I hereby certify that I inspected the electrical insfalla6on described herein on the dates stated:
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Request Date: Rough-in Inspectian Required? ❑ Yes No Inspection pther Than Raugh-In: dy Now ❑ Will Call
�' 4'—Q You must call the inspector when readyl Date Ready�
I certify that I am the �CENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at::