P - 79809REQUEST FOR ELECTRICAL INSPECTION
���, Minnesota Board of Electricity
1� 218 ��`t f '�� �821 University Atrenue ��i� S-128, Saint Paul, Minnesota 55104
, � � (651) 642-0800 TTY/M!? ��� 1-800-627-3529
www.electricity.state.mn s � �
Identity the work covered by this request:
❑ NEW ❑ REMODEL ADDITION ❑ REPAIR °�D
G ERAL FEES Outdoor Li htin Standard �$t
SERVICES / POWER SUPPLIES Traffic Si nal Standard @$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am re �$50 Transformers u to 10 KVA �$10
Above 800 Amoere �$75 Transformers over 10 KVA �$20
0 to 200 Ampere � $5
Above 200 Ampere � $10
RM, COMMUNICATION, REMOTE CONTROL, SIGI
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
.TIFAMILY DWELLINGS (PER UNI�
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
LigMing Retrofit � $25 per FbRUre
CeMer Pivot IrtiQabon Boom � $40
Manufactured Home Park Lots � S25 w`.. �.
Transformer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit (� $B(
Additional Ins ection Tri s�$20
Investi ative Fee
Reinscection Fee � $20
S ial Ins ection �$30 r Hour ""�'"'
Special InspecUOn � $.31 per Mile
_ �II$INSTALLATION MAY BE ORDERED DISCONNECTI
FOR OFFICE USE ONIY
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tlre electrical installaGon
total fee is
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IRequest at � Fiough-in Inspection Required? ny�v� es ❑ No Inspection Other Than Rough-In: ❑ Ready Now Will Call
l���/Q � I You must call the inspector when f§adyl I Date Ready: � � I.
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I certify that I am the ❑ UCENSED COMfRACTOR ❑ COMPAMY ❑ OWNER and hereby request inspection of the electrical work at