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2. Note:

   Please make sure you have sufficient time for completion as this form will not save progress for use at a later time. 

   Upon submission, it will be e-mailed to the utility shop office personnel, including the master electrician. 

   Please call 763-576-2903 with any questions.

4. Appointment Confirmation Preference*

   1. Email
   2. Phone Call
6. Send Appointment Confirmation to*

   1. Electrical Contractor
   2. Customer
8. Customer First Name*

   Name(s) on EV application.

9. Customer Last Name*
11. Service Address*
13. City
14. State
15. Zip Code
17. Customer Email
18. Customer Phone Number
20. Is the location of project installation the same as the Service Address?*

    1. Yes
    2. No
22. Installation Location Address:

    (if different from Service Address above)

    Single location only. Do NOT include multiple locations please.

24. Electrical Contractor

    If applicable

26. Contractor Email Address
27. Contractor Phone Number
29. The customer or contractor must be present at this meeting.
31. Is the Contractor the person attending this meeting?*

    1. Yes
    2. No, there will be someone else attending this meeting.
33. Name of Representative or Contractor Attending*
35. Please select three dates for potential anti-islanding appointment times.

    NOTE:

    1. Dates should be in order of preference from first to last choice.

    2 .Customer or Contractor must be present at this appointment.

    3. Select any date/time span from 8 a.m. to 2 p.m. Monday through Friday.  
         (Regular Business Days only, no holidays or weekends)

37. Date and time span - First Choice*
    Date and time span - First Choice Start Date

    Date and time span - First Choice Start Time

    —

    Date and time span - First Choice End Date

    Date and time span - First Choice End Time
39. Date and time span - Second Choice
    Date and time span - Second Choice Start Date

    Date and time span - Second Choice Start Time

    —

    Date and time span - Second Choice End Date

    Date and time span - Second Choice End Time
41. Date and time span - Last Choice
    Date and time span - Last Choice Start Date

    Date and time span - Last Choice Start Time

    —

    Date and time span - Last Choice End Date

    Date and time span - Last Choice End Time
43. Comments?

    Anything you would like us to know regarding your appointment request.

45. Next Step:

    We will be in touch as soon as possible to confirm an appointment date and time. 

    
    

Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field