P - 81681REQUEST FOR ELECTRICAL INSPECTION
����A �^� m a Minnesota Board of Electricity —
� b� b 182f University Avenue Suite S-)28, Saint Paul, Minnesota 55104
� � � � (651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us
identiTy the work covered by this request:
❑ NEW ❑ REMODEL ❑ADDITION ❑ REPAIR � 1 i � �/U � �/. �� PL�/ // � �G
0 to 400 Ampere � $25
401 to 800 Ampere � $50
Above 800 Ampere � $75
�UITS / FEEDERS
0 to 200 Ampere � $5
Above 200 Ampere � $10
RM, COMMUNICAT�ON, REMOTE CONTROL,
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FI
.TIFAMILY DWELLINGS (PER UNIn
3 to 12 Units �$50 Per Unit
Each Addifional Unit � $25
OTHER ADDITIONAL FEES
Lighting Retrofd � $.25 per Fixture
Center PNot Irri ation Boom �$40
Manufactured Home Park Lots �$2 U,
Traffic Si nal Standard � $5
Su lemental Fee � $20,
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortner / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Suppty up to 500 Amperes, All,
Circuits and Two Inspection Trips Each Dwellin Unit �$80
Additional Ins ction Tri s�$20
Investi ative Fee
Reinsoection Fee � $20
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S ecial Ins ection �$30 er Hour """""''"�'"'"
Special Inspection � $.31 per Mile �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED
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total fee is
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nequea[ a[e: � Rough-in� Inspection Required? ❑ Yes ❑ No Inspection Other Than Rou h-In:
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� t1 You must call the inspector when ready! Date Ready:
I certify that I am the �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: