4.1. ERMUSR 12-17-2019 - Laserfiche WebLink

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SCHEDULE 3 - DISTRIBUTED ENERGY RESOURCES INTERCONNECTION PROCESS Point of Interconnection Additional Information Is the proposed interconnection to an existing service? (If no, applicant is Yes No to skip to the next section.) Customer Name: Customer Account Number: Existing loads at site (kW AC): List future additional loads planned for at site (in kW AC): Project Contact Information Full Name: Name of Business: Street Address: City: State: Zip Code: Email: Phone: Payment and Agreement There is a non-refundable $300 fee for the construction of a pre-application report. By signing this document, I acknowledge and understand that: Neither review of this application nor construction of any report shall begin until the full amount of the fee has been paid to Elk River Municipal Utilities. The Utility shall provide a report with only the available information on the proposed point of interconnection. The information provided by the Utility may become outdated and not useful at the time of submission of a complete Interconnection Application. The confidentiality provision as listed in Section 12.1 of the Overview Process of the Municipal Minnesota Distributed Energy Resource Interconnection Process apply. Upon receipt of the report no guarantee is made by the Utility that a future Interconnection Application will be approved for this proposed site. ___________________________________________ ________________________ Applicant Signature: Date: ***Please print clearly or type and return completed along with any additional documentation*** ELK RIVER MUNICIPAL UTILITIES 2 230