P - 81866� REQUEST FOR ELECTRICAL INSPECTION
�—•O � � ` � � � � Minnesota Board of Electricity "Y
�e 1821 University Avenue Suite S-128, Saint Paul, Mi esota 55104
(65i) 642-0800 TfY/MRS 1-500-627-3529��
www.electriciry.state.mn.us �� ""'
Identity the work covered 6y this request:
❑ NEW ❑ REMODEL ❑ ADDITION
401 to 800 Ampere �
Above 800 Amuere �
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CON7ROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Dev'�ce or Aooaratus �$.50
Additional Unit � $25
OTHER ADDITIONAL
Home Park Lots �
Vehicle Park Sites �
rclino Insoectlon � $;
Outdoor Lighting Standard � $t
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer I Power Su I for Si ns / Oulline ' hGn �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service anNor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$80
Additional Inspection Trips � $20
� Inves6qative Fee
that I insoected the electrical
total fee is
�al inspection � $.31 per Mile _ /� - j� � �3
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFlCE USE ONLY
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�R uest Date: Rough-in Inspectan Requfred? ❑ Yes No Inspection Other Than Rough-In: eady Now � Will Call
� �`—'� ( You must call the inspector when readyl Date Ready:
I certiiy that I am the ;�ENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: