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REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-OSOO llY/MRS 1-800-627-3529 www.edectricity.state.mn.us
Fee
Includes the Service and/or Power Supply up to 500 Amperes, Ap
Cirarits and Twro Inspec.fion Trips Each Dwellir�g Un(t @$80
� Reinsp�on Fee @ $20
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I'ALLATION MAY BE ORDERED DISCONNEGTED IF NOT COMPLETED WITF
FOR OFFtCE USE ONIY
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I certify tl�at I am tha �UCENSED CONTRACTOR ❑ COMPANY ❑ OWNER and fiereby requ�t insp�tlon of the electrical work at
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