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2. 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 billing representatives.

   Please call 763-576-2750, phone option 3, with any questions.

4. Appointment Confirmation Preference*

   1. Email
   2. Phone Call
6. Customer First Name*

   Name(s) on utility billing account.

7. Customer Last Name*
9. Service Address*
11. City
12. State
13. Zip Code
15. Is the location of meter installation the same as the Service Address?*

    1. Yes
    2. No
17. Installation Location:

    (if different from Service Address above)

    Single location only. Do NOT include multiple locations please.

19. Someone must be present for this meeting.

    An AMU employee will need to enter inside the building in order to install the water meter.

21. Is the customer the person attending this meeting?*

    1. Yes
    2. No, there will be someone else attending this meeting.
23. Contact Name*
25. Contact Relation to Customer
27. Contact Email Address
28. Contact Phone Number*
30. Please select three dates for potential meter installation appointment times.

    NOTE:

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

    2 . Someone must be present at this appointment.

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

32. 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
34. 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
36. 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
38. Comments?

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

40. Next Step:

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

Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field