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2. Note:
   This form will be e-mailed directly to Utility Billing Representatives. If you prefer to call during business hours, the utility billing department can be reached at 763-576-2750 with phone option 3 to speak to a live person. Fields marked with asterisk * are required.
4. First Name*
5. Last Name*
7. Email Address*
8. Phone Number
10. Service Address
12. City
13. State
14. Zip Code
16. Description*
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field