Residential Application

CUSTOMER BILLING INFORMATION

Grant PUD Billing Account Number*

Account Number can only contain numbers

Primary Customer Name*

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Mailing Address*

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City*

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State*

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Zip*

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E-mail*

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Phone*

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Secondary

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Do you have a person, contractor or engineer that represents you on this project?*

Yes

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Primary Contact Person/Contractor*

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Phone*

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E-mail Address:*

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SERVICE LOCATION

Parcel Number*

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Address*

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City*

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Zip*

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Plat Name

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Plat Phase

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Block Number:

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Lot Number

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SERVICE REQUEST TYPE:

New or Existing Service?*

New

Existing

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If existing, are you modifying or up-sizing the service? *

Modifying

Up-sizing

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House size (Sq Ft)

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Anticipated KW Usage (including HVAC)

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Shop size (Sq Ft)

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Anticipated KW Usage (including HVAC):

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Service Size in Amps*

200

400 (320 continuous)

Over 400 (CT Meter)

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Building Type*

Stick Built

Manufactured Home

Other

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Please Specify

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Future or Additional Load or Service Specific Comment

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VOLTAGE INFORMATION

Voltage*

Single Phase 120/240

Other

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Please Specify

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Installation Type

Underground

Overhead

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ELECTRIC VEHICLE (EV) CHARGER:

For internal purposes only – Grant PUD does not install EV chargers.

Do you plan to install high demand electrical devices such as EV chargers, on-demand water heaters, pool pumps/heaters, etc. ?*

Yes

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EV chargers

On-demand water heaters

Pool pumps/heaters

Other

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Other Device

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CONSTRUCTION TEMPORARY SERVICE

Will you need a temporary service for construction?*

Yes

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DEVELOPERS

Is this a residential plat or development like an apartment complex?*

Yes

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To proceed with the engineering and determination of charges for this project, the following information will be required:

Plats and Apartments:

City or County approved plat drawings with assigned addresses
Civil engineering drawings (plans that show all other utilities)
Electrical load and service size per lot, apartment, or unit.
Developer and Engineer contact information

If this project is part of a larger phased development, please provide the site plan that shows the full project.

Full project site plan

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Are these attached?

Yes

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Please tell us why

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Do you have a site plan? *

Yes

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Please tell us why*

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Please attach*

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Please attach Second*

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RIGHTS AND OBLIGATIONS

Public Utility District No. 2 of Grant County, Washington (Grant PUD) will build the necessary electrical facilities on your property. In return, you give Grant PUD permission to construct, operate, patrol, maintain, and remove overhead and/or underground electrical distribution lines and related equipment to include; Fiber optic and gateway facilities.

Grant PUD maintains the right to clear the area where the distribution equipment and fiber optic facilities are located on the customer's property. Grant PUD will also ensure the property is kept clear of brush, trees, timber, structures, improvements, and all fire hazards around our equipment.

The customer agrees to not place, construct, or maintain any building, structures, or other improvements within a 10-foot area of Grant PUD electrical or fiber optic facilities. The customer agrees not to reduce or enlarge the required minimum clearances between the ground and any overhead or underground power or fiber optic lines. Failure to comply with these requirements will result in Grant PUD enforcing the requirements at the expense of the customer.

Legal Landowner of Record Signature

Your signature indicates you have read and agree to the Conditions stated in the “Rights and Obligations” section. The customer understands the work requested and authorizes Grant PUD to begin work as listed on the Service Connection Agreement form.The customer agrees to pay all charges associated with Construction.

Print Name*

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Signature*

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Date*

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Service Application