4.1. ERMUSR 12-17-2019 - Laserfiche WebLink

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SCHEDULE 3 - DISTRIBUTED ENERGY RESOURCES INTERCONNECTION PROCESS Interconnection Agreement* Proposed DER interconnections that are also deemed Qualifying Facilities less than 40 kW AC under Minnesota Statutes §Uniform Contract for Cogeneration and Small Power Production Facilities. Included in this agreement are payment terms for excess power generated by the proposed DER system the Utility may purchaseUniform Contract for Cogeneration and Small Power Production Facilities, the Interconnection Customer may choose to instead sign the Municipal Minnesota Interconnection Agreement (MMIA). The Interconnection Customer requests an MMIA to be executed in lieu of the Yes No Uniform Contract for Cogeneration and Small Power Production Facilities. Disclaimers Must be completed by Interconnection Customer * Initials The Interconnection Customer has opportunities to request a timeline extension during the interconnection process. Failure by the Interconnection Customer to meet or request an extension for a timeline outlined in the Interconnection Process could result in a withdrawn queue position and the need to re-apply. on submitted under the Fast Track Process may be moved into the Study Process if engineering screens are failed during the Interconnection Application review. Application Signature Must be completed by Interconnection Customer * I designate the individual or company listed as my Application Agent to serve as my agent for the purpose of coordinating with the Area EPS Operators on my behalf __________ throughout the interconnection process. Initials I hereby certify that, to the best of my knowledge, the information provided in this Application is true, and that I have appropriate Site Control in conformance with the Interconnection Process. I agree to abide by the Municipal Minnesota Distributed Energy Resource Interconnection Process (M-MIP) and will inform the Utility if the proposed DER system changes from the details listed in this Interconnection Application. ___________________________________________ ________________________ Applicant Signature: Date: ***Please print clearly or type and return completed along with any additional documentation*** ELK RIVER MUNICIPAL UTILITIES 9 246