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WATER CONSERVATION REBATE APPLICATION <br />ERMUMN.COM | 763.441.2020 | 13069 ORONO PARKWAY | PO BOX 430 | ELK RIVER, MN 55330-0430 <br /> CUSTOMER INFORMATION <br />Name Account # <br />Address <br />City State Zip <br />Phone Email <br /> <br /> APPLIANCE INFORMATION <br />Appliance Type Brand Model # <br />Appliance Purchased (please fill out one form for each item): <br /> Clothes Washer - Must be ENERGY STAR® certified and have a water factor of 5.5 or less to quality for $25 rebate. <br /> Dishwasher - Must be ENERGY STAR® certified to quality for $25 rebate. <br /> Faucet - Must be WaterSense labeled to quality for $10 rebate. <br /> Toilet - Must be WaterSense labeled and have a rating of 1.28 gallons per flush or less to qualify for $25 rebate. <br /> Smart Irrigation Controller - Must be WaterSense labeled to qualify for a rebate of up to 50%, not to <br /> exceed $250, for the purchase and installation of a smart irrigation controller. The controller must be linked <br /> to local weather via internet or phone connection. <br />Date of Purchase Copy of Receipt or Sales Invoice Attached <br />• Contact our office at 763.441.2020 prior to purchase to ensure funds are still available. <br />• Purchase qualifying fixtures or appliances. <br />• Complete Water Conservation Rebate Application by December 31. <br />• Submit rebate application to ERMU, including itemized cash register receipt or sales invoice indicating <br /> the brand and model purchased. Application and receipts can be submitted via mail or electronically <br /> on our website at www.ERMUMN.com. <br />• Applicant must have ERMU water service to qualify for the rebate. <br />• All rebates will be given in the form of a credit on your water utility bill. <br /> IMPORTANT <br />98