Residential Construction Request

1. Contact Information

Last Name *This question is required.

First Name *This question is required.

Middle Name *This question is required.

Contact Role *This question is required.

Company *This question is required.

Daytime Phone *This question is required.

Extension

Comments

Cell

Extension

Comments

Fax

Extension

Comments

Email This question requires a valid email address.

2. Mailing Address

Address *This question is required.

Apt/Suite Number

City *This question is required.

State *This question is required.

Zip Code *This question is required. This question requires a valid number format.

Required method of contact is email.

3. Customer Responsible

Name

Role

Email *This question is required. This question requires a valid email address.

4. Third Party Contact (Contractor/Electrician)

Name

Company

Role

Email This question requires a valid email address.

Email is used for communication in regards to requested work (I.E. moving through steps in process, estimation quotes, etc.)

5. Billing Information

Existing Minnesota Power Customer *This question is required.

Existing Account Number *This question is required.

Last Name *This question is required.

First Name *This question is required.

Middle Name *This question is required.

Employer *This question is required.

6. Additional Name

Last Name

First Name

Middle Name

Employer

7. Billing Address

Address *This question is required.

Apt/Suite Number

City *This question is required.

State *This question is required.

Zip Code *This question is required. This question requires a valid number format.

Primary Phone *This question is required.

Extension

Comments

Daytime Phone *This question is required.

Extension

Comments

Cell

Extension

Comments

Fax

Extension

Comments

Email This question requires a valid email address.

8. Project Location

Address *This question is required.

Apt/Suite Number

City *This question is required.

State *This question is required.

Zip Code *This question is required. This question requires a valid number format.

Is this a multiple-unit building? *This question is required.

If multiple-unit building, number of units *This question is required.

Nearest cross street/road or closest neighbor's address *This question is required.

Legal Description

Plat Name
Lot Number
Block Number
City/Twp Name
Twp Number

County
Range
Section
1/4 Section
Parcel*This question is required.

Project Information

9. Building Type *This question is required.

Please enter an 'other' value for this selection.

10. Current Construction Status *This question is required.

11. Who should be billed for electric usage during construction? *This question is required.

12. Customer Construction Start Date *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

13. Electric Target Install Date *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

14. Are any members of your household on life support equipment that relies on electrical services?

15. Contractor Information

Space Cell	General Contractor	Electrical Contractor	Architect (A&E Firm)	Mechanical Contractor
Company	Company: General Contractor	Company: Electrical Contractor	Company: Architect (A&E Firm)	Company: Mechanical Contractor
Contact Person	Contact Person: General Contractor	Contact Person: Electrical Contractor	Contact Person: Architect (A&E Firm)	Contact Person: Mechanical Contractor
Phone Number	Phone Number: General Contractor	Phone Number: Electrical Contractor	Phone Number: Architect (A&E Firm)	Phone Number: Mechanical Contractor
Fax Number	Fax Number: General Contractor	Fax Number: Electrical Contractor	Fax Number: Architect (A&E Firm)	Fax Number: Mechanical Contractor
Email	Email: General Contractor	Email: Electrical Contractor	Email: Architect (A&E Firm)	Email: Mechanical Contractor

16. Service Specifications

Are you installing electric heat? *This question is required.

17. Contact us at 218-355-2843 or email DualFuelSupport@mnpower.com for more information on the Electric Heating Programs listed below.

18. Electric Heating System

Central Storage Hot Water System
Centrally-Ducted Storage Furnace
Slab Heat-Electric Boiler
Thermal Storage Unit Heaters
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

19. Ground Source Heat Pump in tons

19. Electric Heat Load Total Wattage / 1000 = __________________kW

20. Electric heat panel size

Please enter an 'other' value for this selection.

21. Non-electric Fuel Source

Fuel Oil
Natural Gas
Propane

Wood
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

22. Non-electric Heating Source

Boiler-Hot Water Baseboard
Boiler-Slab Heat
Fireplace/Stove

Forced Air Furnace
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

23. Temporary Service

24. General Service

Panel Size *This question is required.

Please enter an 'other' value for this selection.

Single Phase Voltage *This question is required.

25. Electric Vehicle Residential EV Rate

Electric Vehicle Load Total Wattage / 1000 = _______________kW

Panel Size

Please enter an 'other' value for this selection.

Single Phase Voltage

26. Comments

27.

Site Plan

*This question is required.

Customers must provide a detailed site plan noting the following:

Where the new structure will be located
Location of existing structures
Distance (feet) structure will be located from roadway
Location of proposed/existing driveway (note if matting has been installed)
Location of well lines, sewer lines, or other potential obstructions
Location of electric panel (service entrance)
Neighboring address and/or nearest intersecting road

Accepted file types: png, gif, jpg, jpeg, doc, docx, xlsx, pdf

File: {{filename}} delete

By signing and completing this application I am certifying I understand and agree to the following:

Any deviation from the electrical design, once established, may result in additional costs for redesign and delays in construction.

Services agreed upon in this application are required to stay in service for a minimum of five years. Customer will be liable for costs to remove Minnesota Power equipment if the five year minimum is not met.

I have read Your Residential Electric Service at: https://www.mnpower.com/CustomerService/ResidentialConstruction

28. Authorization

Signature *This question is required.

Clear

Signature of

Date *This question is required.