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4.1. ERMUSR 02-09-2016
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4.1. ERMUSR 02-09-2016
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2/11/2016 2:33:26 PM
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2/9/2016 2:16:30 PM
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City Government
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ERMUSR
date
2/9/2016
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Elk River -- <br /> Municipal Utilities <br /> 13069 Orono Parkway 763.441.2020 <br /> PO Box 430 Fax:763.441.8079 <br /> Elk River,MN 55330 www.elkriverutilities.com <br /> Commercial Electric Service Application <br /> Service Address: Unit/Suite: <br /> City: State: Zip: <br /> Business Name (as shown on tax return): <br /> DBA: <br /> Type of Business (retail,restaurant,production, general office) <br /> Federal Tax ID#: Social Security#(Req. for Sole-Proprietor) <br /> Authorized Signer/Contact: Title: <br /> Contact Phone: Email: <br /> Business Phone: Fax: <br /> Accounts Payable Contact: Phone: <br /> Is the business Sales Tax Exempt? n Yes n No If yes, complete and return ST3 form. <br /> Check one: n Rent ❑ Own <br /> If rent, Name of Property Manager/Owner: Phone: <br /> If own,Name of Property Manager: Phone: <br /> Lease Start/Closing Date: Service Start Date: <br /> 1 <br /> 95 <br />
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