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2. Use this form to request an appointment for temporary disconnection of power with Anoka Municipal Utility (AMU). Schedule a time to temporarily disconnect line side power or  remove a meter to complete a project during AMU business hours.

4. Note:

   Please make sure you have sufficient time for completion as this form will not save progress for use at a later time. 

   Upon submission, it will be e-mailed to the utility shop office personnel, including the master electrician. 

   Please call 763-576-2903 with any questions.

6. Type of Disconnect*

   1. Load side (temporary meter removed)
   2. Line side (temporary full disconnect)
   3. Both, temporary line side disconnect with meter removed.
   4. Not sure
8. Reason for Disconnection Request*

   1. Meter Install/Change
   2. Customer owned UG repair
   3. Panel change
   4. Mast repair
   5. Other
10. Please give a brief reason for disconnection request.*
12. Reason for Meter Install/Change*

    1. Interconnection Meter (Ex. Solar)
    2. EV Meter Install
    3. Other
14. Please describe.*
16. Appointment Confirmation Preference*

    1. Email
    2. Phone Call
18. Is the customer the person attending this meeting?*

    1. Yes
    2. No, there will be someone else attending this meeting.
20. Send Appointment Confirmation to*

    1. Customer
    2. Person Attending
22. Is the Application Agent the person attending this meeting?*

    1. Yes
    2. No, there will be someone else attending this meeting.
24. Name of Person Attending*
26. Send Appointment Confirmation to*

    1. Application Agent
    2. Customer
28. Contact Email
29. Contact Phone Number
31. DER Vendor

    Interconnection Company if applicable

32. Application Agent Name

    Ex. Solar Contact

34. Application Agent Email Address
35. Application Agent Phone Number*
37. Customer First Name*

    Name on application. Contact Name if for a business.

38. Customer Last Name*
40. Business Name

    Customer Business Name if applicable.

42. Service Address*
44. City
45. State
46. Zip Code
48. Is the location of project installation the same as the Service Address?*

    1. Yes
    2. No
50. Installation Location Address:

    (if different from Service Address above)

    Single location only. Do NOT include multiple locations please.

52. Please select three dates for potential disconnection appointment times.

    NOTE:

    1. Dates should be in order of preference from first to last choice.

    2. Select any date/time span from 8 a.m. to 2 p.m. Monday through Friday.  
         (Regular Business Days only, no holidays or weekends)

    3. This is a free service, however, power must be restored by 3pm to avoid paying overtime charges.  (Other option is to re-connect next day during business hours - please note in the comments if applicable)

54. Date and time span - First Choice*
    Date and time span - First Choice Start Date

    Date and time span - First Choice Start Time

    —

    Date and time span - First Choice End Date

    Date and time span - First Choice End Time
56. Date and time span - Second Choice
    Date and time span - Second Choice Start Date

    Date and time span - Second Choice Start Time

    —

    Date and time span - Second Choice End Date

    Date and time span - Second Choice End Time
58. Date and time span - Last Choice
    Date and time span - Last Choice Start Date

    Date and time span - Last Choice Start Time

    —

    Date and time span - Last Choice End Date

    Date and time span - Last Choice End Time
60. Comments?

    Anything you would like us to know regarding your appointment request.

62. Next Step:

    We will be in touch as soon as possible to confirm an appointment date and time. 

Leave This Blank:


63. 1. Receive an email copy of this form.
64. Email address

    This field is not part of the form submission.

65. Submit

* indicates a required field