P - 77735REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Elec�ricity ��
1� 3 4 7- 3 2 5 1821 University Ave�ue Suite S-128, Saint Paul, Minnesota 55104
... (651) 642-OS00 TTY/MRS 1-800-627-3529 - _
www. electrici ty. state. mn. us
Identify the work covered by this request: v ��y
❑ NEW ❑ REMODEL �ADDITION ❑ REPAIR � L � ���J �--
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traific Si nal Standard �$5
0 to 400 Am re�$25 Su lemental Fee �$20
401 to 800 Am ere (� $50 Transformers u to 10 KVA �$10
Above 800 Am re �$75 Transformers over 10 KVA �$20
CIRCUITS / FEEDERS Transformer / Power Su I for Si ns / Outline Li hti �$5
0 to 200 Am re� a5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re �$10 Includes the Service andlor Power Suppty up to 500 Amperes, All
AIARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspec6on Trips Each Dwellin Unft �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ion Tri s�$20
Each S stem Device or A aratus �$.50 Investi tive Fee
ADDITIONS TO THE GENERAL FEES Reinsoection Fee �$20
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Li htin Retrofit �$25 r Fi�Aure
Center Pivot I' tion Boom �$40
Manufactured Home Park Lots (� $
Recreational Vehicle Park Sites �
rate Bondi I ion � $20
S' I ' n�$30 r Hour
S �al I ' n� a.31 r Mile
THIS INSTALLATION MAY BE ORDEREO
total fee is $20) I7l
the electrical installation described herein on the dates sfated:
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FOR OFFICE USE ONLY
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R Da : Rough-in Inspection Required? Yes ❑ No Inspection Other Than Rough-In: ❑ Ready Now Will Call
�(p �� You must call the inspector when rea . �[% Date Ready:
I ceRiiy that I am the ❑ LICENSED CONTRACTOR'- ❑ COMPANY � OWNER and hereby request inspection of the electrical work at: