P - 77522REQUEST FOR ELECTRICAL INSPECTION _��"�
2� o� r�',� f1 �� � Minnesota Board of Electricity �: �
�y' 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 �
• (651)642-0800TTY/MRS 1-800-627-3529 www.electricity.state.mn.us ?�!
Describe -using th ack of e whit py'rf necessary - he rk ered by this request:
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GEN FEES Outdoor Lightin Standard @$1
SERVICES I POWER SUPPLIES Traffic Si nal Standard $5
0 to 400 Ampere $25 Supplemental Fee @$20
401 to 800 Am re $50 Transformers u to 10 KVA $10
Above 800 Am re $75 Transformers over 10 KVA $ 20
IRCUITS I FEEDERS Transformer / Power Su I for Si ns I Outline Li htin $5
0 to 200 Am re $5 ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re $70 Includes the Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CANTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelling UnR @$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ion Tri s $20
Each S stem Device or Apparatus $.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reins ection Fee $20
MULTIFAMILY DWELLINGS PER UNIT TOTAL FEE
3 to t2 Units @$50 per unit (minimum total fee is $20)
Each Additional Unit @$25 Tws ut�n Foa iNSVecrat use on�r
OTHER ADDITIONAL FEES
Li htin ROtfofit $25 pef Fixture I hereby certiy thal I inspeded the electrical installation described herein on Ne dates stated:
Center Pivot Irri ation Boom $40 RWGH IN oA,E
Manufactured Home Park Lots $25
Recreational Vehicle Park Sites $5 F�u�sPecr�«� oq,�
Se arate Bondin ins ection $20 -e–�—�– s•�– � �' 7
Speciallnspection $30perHour EXPIREDIAfl4N00NED op,�
Special ins ion $.3t r Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12 MONTHS
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;' ) Rough-in Inspection Required7 ❑ Yes� Inspec[ion Othe an ou�
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You must call the inspector when ready! Date Ready:
I certify that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request
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of the electrical work at:
i o- y�qng Nurt�e � nGuding Area
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ster Eledrician or Power Limited T
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Two (2) Ph ne umbers Including Area
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