P - 75872REGIUEST FOR ELECTRICAL INSPECTION
1 3 4 7 4 7 9� Minnesota Board of Electricity
� � 1821 Untversity Avenue Sufte 5-128, Saird Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
❑ NEW REMODEI ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re�$25
401 to 800 re � $50
Above 800 re � $75
CIRCUITS ! FEEDERS
0 to 2�1 Am re �$5
Above � re � $10
ALARM, COMMUNICATION, REMOTE CONTHOI, SI
CIRCUtTS, CIRCUITS OF LESS THAN 50 VOLTS
F�ch m Dsvice or � $.50
ADDRIONS TO THE GENERAL FEE
MULTIFAMILY DWEWNGS ER UN
3 to 12 Unib �$50 Per Unit
Eech Addido�l Unft � $25
OTHER ADDITIONAL FEES
- LI htl Retrofit (� $25 r Fbcture
CeMer Piaot Ir� on Boom �$40
Manutactured Home Perk Lots � �.5
R�atior�l Vehide Park Sit� � $5
� on C� $20
S I 'on � $30 r Hour
S�cial Irdsu�tlon � $.31 �r Mile
Trafflc Si nal SYandazd � $5
Su rlemerdal Fee C� $20
Trarreformars u � to 10 KVA �$10
Transformers over 10 KVA � $20
Trensiormer / Power I for Si r�s / Outtlne Li �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Ir�cludes the Service and/or Power Suppty up to 500 Amperes, Ad
Ciraiits ar�d Two I�pec6on Trips Each Dwe4in Unit (� �C
Iq i3 8
Add'ih'o�rel Ir� �ection Tri s � �0
Imra�ti ative Fee
Rehisoection Fee � $20
s
total fee is
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I here certBy tlwt I insp�ed the ele�al h�e0atla� described hereh� on tlie dat� s�ted:
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FOR OFFlCE USE ONLY
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I cerbiy tlmt I am �e ❑ LICENSED CONTRACTOR
Jab Addr�ss (Street, Box, or Route No.)
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TED WITHIN 3�MONTHS
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IPANY � OWNER end hereby request inspectlon of the electric�l work et
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�i Contractor / Company Name I Contrector Llcer6se N�unber
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�-13 7HP2000 _ BOAAD OF ELECTAICRY COPY
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