P - 81841REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
�� 0 Q�� Q�% �°� 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
t `� �� � �' w° (651) 642-0800 TTY/MRS 1-500-627-3529
` www.electricity.state.mn.us
IdentiTy the work covered by this request:
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❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR �,� r Cr �
GENERAL FEES Outdoor Li htin Standard �$t
SERVICES I POWER SUPPLIES Traffic Si nal Standard 8$5
0 to 400 Am ere �$25 Su lemental Fee C� $20
401 to 800 Am ere �$50 Transformers u to 10 KVA �$10
Above 800 Am ere �$75 Transformers over 10 KVA �$20
CIRCUITS / FEEDERS Transformer / Power Su i for Si ns / Outline Li htin �$5
0 to 200 Am ere �$5 ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re �$10 Includes the Service ancllor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwellin Unft �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins edion Tri �$20
Each S em Device or aratus �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reinsoection Fee �$20
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Ligh6ng Retrofit � $25 per Fi�ure
CeMer Pivot Irtigation Boom � $40
Manufachired Fbme Park Lots � $2� �� ;-
Recreational Vehicle Park Sites
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S ecial Inspection �$.31 per Mile � �� �G •6—c.j �
THIS INSTALLATION MAY BE ORDERED DISCONNE NOT COMPLETED WITHIN 18 MONTHS
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Request Date: Rough-in Inspectlon Requiredl ❑ Yes No lnspectlon Other Than RougA-In: eady Now � WIII Call
You must call the inspectw when readyi Date Ready: �
I certify that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the etectrical work at
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