REQUEST FOR ELECTRIC SERVICE



WORK ORDER NUMBER _________________________

Please submit one form for each job number requested.

| TYPE OF REQUEST: NEW CHANGE REMOVAL |

|Person Completing Form: |      |Telephone Number: |(     )      -      |

|Ratepayer Information: |

|      | |      |

|(Bill Account Number) | |(Meter Number) for Change Request |

|      | |      |

|(Ratepayer Name) | |(Ratepayer Phone) |

|      | |      |

|(Service Address, City, State Zip) | |(Mailing Address for Ratepayer) |

|      | |      |

|(Township) | |(County) |

|Directions to site:       |

|Development’s Name: |      |Nearest Neighbor: |      |

|Section/Lot#: |      |(If Known)       |

|Temp: overhead underground or Removal |Your Approx. Ready Date:       |

|Perm: overhead underground |Dependent on completion of all requirements by customer and PPL work |

| |schedule. |

|Electrician’s Name: |      |Builder’s Name: |      |

|Telephone Number: |      |Telephone Number: |      |

|Nearest PPL Pole or Transformer #: |      |

|Distance to PPL Pole: 200 Ft. |

| |

|To Serve:       (Single home=1, Double=2, Townhouse=3, Apartment=4, Mobile Home=5, |

| TV Cable=6, Billboard=7, Farm=8, Commerical=9) Type Business:       |

| |

|Appliances:       1=Elec Range, 2=Elec Water Heater, 3=Tankless Wtr Htr, 4=Both 1&2, 5=Both 1&3, 6=None |

|Heat Source: Electric Gas Oil |

|Central Air Conditioning : BTUs       or, Number of Window Units       |

|Electric Heat: Type       Load:       Sq. footage of heated area       |

| |

|Service Entrance Size:       Amps Progress: Vacant lot Foundation Framed |

|Meter Base installed? Yes No Inspected? Yes No |

| | |

|COMMENTS:       | |A |B |C | |

| | |********************* | |

| | L * | |Rear | |* D |

| | * | | | |* |

|Preferred Meter Location:       | K * |Left | |Right |* E |

| |* | | | |* |

| | | | |

|(Final meter location to be determined by PPL designer who will contact you within the| J * | | | |* F |

|next eight work days.) | | | | | |

| | |Front | |

| | |********************* | |

| | |I |H |G | |

| | | | | | |

|Primary Contact Person:       |Daytime Telephone#: (     )      -      |

| |Best Time To Reach:       |

|      | |

| (Mailing Address, City, State, Zip) |

|Fax or Mail Job number(s) to: |      |

|Signature of Ratepayer: | | |Date: |      |

| |

-----------------------

PPL Electric Utilities

827 Hausman Road, Allentown, PA 18104-9392

Fax 484-634-3484 Telephone 1-877-220-6016

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download