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Elk River <br />Municipal Utilities <br />�atieTseso APPLIANCE AND HOME EFFICIENCY <br />m @ms A mr RESIDENTIAL REBATE APPLICATION <br />EPA cc <br />CLOTHES DRYER (Must be ENERGY STAR®certified) REBATE: $40 / UNIT <br />Quantity <br />Type (select one in each group) ❑ Gas ❑ Electric ❑ Compact ❑ Standard ❑ Vented ❑ Ventless <br />Manufacturer Name Model Number Date of Install <br />CLOTHES WASHER (Must be ENERGY STAR®certified) <br />Quantity Building Type (select one) ❑ Reverse Cycle <br />Type (select one) ❑ Front Load ❑ Top Load Capacity (cubic feet) <br />Drying Energy Source (select one) ❑ Gas ❑ Electric ❑ Unknown <br />Manufacturer Name Model Number Date of Install <br />REBATE: $40 / UNIT <br />❑ Louvered <br />DEHUMIDIFIER (Must be ENERGY STAR" certified AND UEF greater than 2) REBATE: $30 / UNIT <br />Quantity Capacity (pints / day) New Unit Energy Factor (UEF) <br />Manufacturer Name <br />D ISHWASH ER (Must be ENERGY STAR® certified) <br />Quantity <br />Manufacturer Name <br />REFRIGERATOR/FREEZER <br />(Must be ENERGY STAR® certified) <br />Quantity <br />Iur.reM101 Ri117-M <br />Type (select one) ❑ Compact <br />Model Number <br />Date of Install <br />REBATE: $40 / UNIT <br />❑ Standard <br />Date of Install <br />REBATE: $100 / UNIT (When buying new and $35 / UNIT <br />recycling an old unit in working order) (When buying new only) <br />Type (select one) ❑ Freezer ❑ Refrigerator ❑ Both <br />Style (select one) ❑ Compact Chest ❑ Compact Upright ❑ Standard Upright <br />Through the Door Ice (select one) ❑ Yes ❑ No Defrost Type (select one) ❑ Manual ❑ Auto ❑ Partial Auto <br />Configuration (select one) ❑ Refrigerator Only ❑ Top Mounted Freezer ❑ Side by Side ❑ Bottom Mounted Freezer <br />Manufacturer Name Model Number Date of Install <br />ADDITIONAL ITEMS THAT QUALIFY FOR REBATES (See below) <br />Select any applicable item(s) below. A representative may need to contact you for additional information. <br />❑ ENERGY STAR® Air Purifier - $35 ❑ ENERGY STAR® Ceiling Fan - $10 ❑ Tier II Power Strip - $20 <br />❑ ENERGY STAR® Ceiling Fan with Integral LED Light - $20 ❑ Variable Speed Pool Pumps w/E.F. < 3.8 - $200 <br />❑ WaterSense-labeled toilet with a rating of 1.28 gallons or fewer per flush - $25 <br />❑ WaterSense- labeled smart irrigation controller and installation - Up to 50% of the device and installation costs. Not to exceed $250 <br />Must be linked to local weather via internet, weatherstation, oran ET waterserver. <br />Manufacturer Name <br />Model Number <br />173 <br />Date of Install <br />