Commercial Construction Request

1. Contact Information

Last Name

First Name

Middle Name

Company

Daytime Phone

Cell Phone

Fax

Email This question requires a valid email address.

2. Mailing Address

Address

Apt/Suite Number

City

State

Zip Code This question requires a valid number format.

Required method of contact is email.

3. Customer Responsible

Name

Role

Email *This question is required.

4. Third Party Contact (Contractor/Electrician)

Name

Company

Role

Email

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

5. Project Location

Site Address *This question is required.

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.

6. 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
Phone Number	Phone Number: General Contractor	Phone Number: Electrical Contractor	Phone Number: Architect (A&E Firm)	Phone Number: Mechanical Contractor
Contact Person	Contact Person: General Contractor	Contact Person: Electrical Contractor	Contact Person: Architect (A&E Firm)	Contact Person: Mechanical Contractor

7. Billing InformationEntity responsible to pay for electric usage AFTER construction (permanent service)

Existing Minnesota Power Customer *This question is required.

Existing Account Number *This question is required.

Company *This question is required.

Business Type *This question is required.

NAICS Code

Doing Business As (DBA) Name

Billing Address *This question is required.

City *This question is required.

State *This question is required.

Zip Code *This question is required.

Primary Phone *This question is required.

Daytime Phone *This question is required.

Cell Phone

Fax

Email This question requires a valid email address.

Tax Exempt?If yes, send copy of ST3 Exemption

8. Temporary Service Size

Will a temporary service be required? *This question is required.

Voltage

Phase

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

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Service Information

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

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

Billing InformationEntity responsible to pay for electric usage DURING construction (temporary service)

Existing Minnesota Power Customer *This question is required.

Existing Account Number *This question is required.

Company *This question is required.

Business Type *This question is required.

NAICS Code

Doing Business As (DBA) Name

Billing Address *This question is required.

City *This question is required.

State *This question is required.

Zip Code *This question is required.

Primary Phone *This question is required.

Daytime Phone *This question is required.

Cell Phone

Fax

Email This question requires a valid email address.

Tax Exempt?If yes, send copy of ST3 Exemption

9. Electrical Engineer/Electrician's Information

Project

Date This question requires a valid date format of MM/DD/YYYY.

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Location/Address

Voltage *This question is required.

Please enter an 'other' value for this selection.

Phase *This question is required.

Electric Utility Load ProfileTo be completed by an electrician or electrical engineer

Space Cell	Single Phase Connected Load (kW)	Estimated Demand Load (kW)
Indoor Lighting	Indoor Lighting: Single Phase Connected Load (kW)	Indoor Lighting: Estimated Demand Load (kW)
Outdoor Lighting	Outdoor Lighting: Single Phase Connected Load (kW)	Outdoor Lighting: Estimated Demand Load (kW)
Motor Load	Motor Load: Single Phase Connected Load (kW)	Motor Load: Estimated Demand Load (kW)
Electrical Heal	Electrical Heal: Single Phase Connected Load (kW)	Electrical Heal: Estimated Demand Load (kW)
Air Conditioning	Air Conditioning: Single Phase Connected Load (kW)	Air Conditioning: Estimated Demand Load (kW)
Kitchen Equipment	Kitchen Equipment: Single Phase Connected Load (kW)	Kitchen Equipment: Estimated Demand Load (kW)
Refrigeration	Refrigeration: Single Phase Connected Load (kW)	Refrigeration: Estimated Demand Load (kW)
Compressor	Compressor: Single Phase Connected Load (kW)	Compressor: Estimated Demand Load (kW)
Receptacles	Receptacles: Single Phase Connected Load (kW)	Receptacles: Estimated Demand Load (kW)
Other	Other: Single Phase Connected Load (kW)	Other: Estimated Demand Load (kW)
Subtotal	Subtotal: Single Phase Connected Load (kW)	Subtotal: Estimated Demand Load (kW)
Existing Loads	Existing Loads: Single Phase Connected Load (kW)	Existing Loads: Estimated Demand Load (kW)
Total *This question is required	Total: Single Phase Connected Load (kW)	Total: Estimated Demand Load (kW)

Electric Utility Load ProfileTo be completed by an electrician or electrical engineer

Space Cell	Three Phase Connected Load (kW)	Estimated Demand Load (kW)
Indoor Lighting	Indoor Lighting: Three Phase Connected Load (kW)	Indoor Lighting: Estimated Demand Load (kW)
Outdoor Lighting	Outdoor Lighting: Three Phase Connected Load (kW)	Outdoor Lighting: Estimated Demand Load (kW)
Motor Load	Motor Load: Three Phase Connected Load (kW)	Motor Load: Estimated Demand Load (kW)
Electrical Heal	Electrical Heal: Three Phase Connected Load (kW)	Electrical Heal: Estimated Demand Load (kW)
Air Conditioning	Air Conditioning: Three Phase Connected Load (kW)	Air Conditioning: Estimated Demand Load (kW)
Kitchen Equipment	Kitchen Equipment: Three Phase Connected Load (kW)	Kitchen Equipment: Estimated Demand Load (kW)
Refrigeration	Refrigeration: Three Phase Connected Load (kW)	Refrigeration: Estimated Demand Load (kW)
Compressor	Compressor: Three Phase Connected Load (kW)	Compressor: Estimated Demand Load (kW)
Receptacles	Receptacles: Three Phase Connected Load (kW)	Receptacles: Estimated Demand Load (kW)
Other	Other: Three Phase Connected Load (kW)	Other: Estimated Demand Load (kW)
Subtotal	Subtotal: Three Phase Connected Load (kW)	Subtotal: Estimated Demand Load (kW)
Existing Loads	Existing Loads: Three Phase Connected Load (kW)	Existing Loads: Estimated Demand Load (kW)
Total *This question is required	Total: Three Phase Connected Load (kW)	Total: Estimated Demand Load (kW)
Largest Motor	Largest Motor: Three Phase Connected Load (kW)	Largest Motor: Estimated Demand Load (kW)

Main Breaker Size *This question is required. Amps

Service Conductor Size *This question is required.

Number of conductors per phase *This question is required.

Metering *This question is required.

Self-contained
CT cabinet
Transition cabinet
Switch gear

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

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10. Heating and Cooling Options

12.

Certified Survey Map or Site Plan

*This question is required.

Customers must provide a certified survey map or 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

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A complete application, along with good communication with your Minnesota Power representative, is the best way to keep your project on track. All information requested shall be completed in its entirety. Incomplete applications will be returned and will cause delays until a complete application has been received.

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 Commercial Electric Service at: https://www.mnpower.com/CustomerService/CommercialConstruction

13. Authorization *This question is required.

Clear

Signature of

14. Date *This question is required. This question requires a valid date format of MM/DD/YYYY.

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