Академический Документы
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Please contact Alliant Energy at 1-800-ALLIANT (800-255-4268) before completing this form.
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SITE INFORMATION
Address / Fire No. Street Lot No.
City / Town / Village (check one and enter name) State Zip
Business Type
Multi-Family (No. of Units ) Commercial Industrial Building Size: Total Sq. Ft. No. of Stories
Business Function
Retail Health Care Industrial Restaurant Large Commercial Education Government SIC Code:
Do you have a similar existing facility? Company Name Building Sq. Ft.
NOTE: If existing facility is not an Alliant Energy customer, please attach copies of utility bills for this facility from the past 12 months.
OWNER INFORMATION
Business Name Federal Tax I.D. No. * Exempt?
Yes No
Business Type
Owner Name (Last/First/MI) Owner Phone No. (day) Owner Phone No. (alternate/mobile)
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Owner Social Security No. * Owner Fax No. Owner E-mail Address
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Additional Contact Person Name Phone No. (day) Phone No. (alternate/mobile)
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* NOTE: Federal I.D. No. is required to complete Turn On for (LLC) and (INC). Social Security No. is required for Sole Proprietorship and Partnership, along with Federal I.D. No., if
available.
BUILDER/CONTRACTOR INFORMATION
Company Name Federal Tax I.D. No.
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Fax No. E-mail Address
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BILLING INFORMATION
Who should be billed for electric/gas installation? Who should be billed for electric/gas usage during construction?
Include a certified survey map and complete set of building plans, with electric and natural gas service locations, motor schedules,
lighting schedules and mechanical schedules.
Phone No. (day) Phone No. (alternate/mobile) Fax No. E-mail Address
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PERMANENT SERVICE
Estimated Date Permanent Electric Service Will Be Needed (MM/DD/YY)
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Service Size
100 Amps 200 Amps 300 Amps Other Amps
Voltage
120/240 (1-PH only) 120/208 277/480 Other
Phase Service Type
Single 3 Phase Underground Overhead
Refrigerated Space (32 to 45 degrees F) Tons Frozen Space (-20 to 10 degrees F) Tons
Process Cooling (32 to 40 degrees F) Tons Process Freezing (-10 to -25 degrees F) Tons
Heating
1 - Phase 3 - Phase
Welders (attach list of welders)
Single Phase Welders Amps Volts Qty. Three Phase Welders Amps Volts Qty.
Miscellaneous
Wall Receptacle Circuits Amps Volts Qty. Wall Receptacle Circuits Amps Volts Qty.
Other
kW kW
kW
Connected Load (kW)
Phone No. (day) Phone No. (alternate/mobile) Fax No. E-mail Address
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Plumbing Contractor Business Name Contact Person Name
Phone No. (day) Phone No. (alternate/mobile) Fax No. E-mail Address
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SERVICE INFORMATION
Estimated Date Permanent Gas Service Will Be Needed (MM/DD/YY) Estimated Date Temporary Gas Service (Heat) Will Be Needed (MM/DD/YY)*
/ / / / Load Pressure
Delivery Pressure (check with heating dealer if unsure of pressure, because there is a charge to change the pressure after installation)
Standard (7" wc) 2 psi 5 psi 10 psi 15 psi Other psi
Wall Construction Meter Location (meter guards are required in traffic areas and will be installed at an additional charge, if necessary)
Masonry Block/Brick Poured Concrete Metal Wall Panel Wood Frame
* Is considered extraordinary and subject to approval.
SPACE HEATING
Indicate the type of facility by placing an "X" in the appropriate box below:
Direct fired make up air units - these are unvented units where the products of combustion are part of the supply air to the 0 Therms
building. These units are typically 96% efficient.
TOTALS
Annual usage of all equipment equals:
0 Therms OR 0 MCF
Page 3 of 4
ECRM158957 REV.8 08/19
Retain per Functional Retention Schedule category FN-18.
ROUTING: Return to Company or email
CustomerCare@alliantenergy.com
WI & IA COMMERCIAL, INDUSTRIAL, MULTI-FAMILY NEW CONSTRUCTION
SERVICE APPLICATION AND AGREEMENT
1. The undersigned applicant(s) (the Customer) understands and agree that prior to installation of underground electric lines or gas piping, the owner of the
property for which utility service is sought (the Landowner) shall have established the final grade of the route and that after installation of the line the
grade shall not be increased or decreased more than 6" without the approval of Alliant Energy (the Company). If the Customer is not the Landowner, the
Customer is responsible for obtaining such agreement in writing from the Landowner and providing same to the Company at no expense to the Company.
3. IOWA ONLY - The Customer does hereby certify that the structure served by the gas and/or electric service line, if completed after April 1, 1984, and if
intended primarily for human occupancy, conforms to the energy conservation requirements adopted under the Iowa Administrative Code Sections 661-
303.2 (103A) and 661-303.3 (103A).
4. INDEMNIFICATION. The Customer shall hold the Company harmless for any damage to persons or property arising out of the use upon the Customer site of
the electric service or gas service furnished to it by the Company. Nothing herein contained shall be construed as relieving the Company from any liability
to its own employees while upon the site of the Customer in the performance of their duty and by the direction of the Company, or as relieving the
Company from any liability to the Customer due to the Company's act of negligence.
5. This agreement shall become effective when acceptance of the application has been signed on behalf of the Company.
6. The Company agrees to return any deposit, with interest, according to the rules and regulations of the applicable State Regulatory Authority.
7. WISCONSIN ONLY - If the property being serviced pursuant to this application is also used as a personal residence, the Customer acknowledges the right
to make written request to the Company that the County Department of Health and Social Services be notified at least 5 calendar days prior to a
scheduled disconnection of service for rule violation or non-payment.
8. WISCONSIN ONLY - Failure to Consume Natural Gas
a. The Customer agrees to begin consuming natural gas within eleven months of installation of the service lateral. If the Customer is not consuming gas
by that time, the Customer agrees to pay each month the applicable Customer Charge on file with the State Regulatory Authority.
b. If the Customer does not begin consuming gas within 10 years of the installation of the service lateral, the service pipe may be removed unless the
Customer agrees to continue to pay each month the applicable Customer Charge on file with the State Regulatory Authority.
c. After the service lateral has been installed, the Customer may not avoid obligations under these agreements by requesting discontinuance of service
or by requesting service under a different rate schedule.
9. The Customer is responsible for notifying the Company of contaminated oil (soil, groundwater, etc.) that may be present on the premises prior to
Company commencing installation or extension of service.
10. If contaminated media is encountered during the installation or extension of service, the Company shall terminate the installation or extension of service
and notify the customer. The customer is responsible for reporting the discovery of contamination to the appropriate agencies.
11. The Company reserves the right to consider alternative service routes, if necessary, to avoid contaminated media.
12. The Customer, or Landowner, is responsible for management of any contaminated media generated during the installation of service. The Customer may
be held liable for additional costs incurred by the Company if contaminated media is encountered during the installation of service.
13. The Customer agrees that the Company may dig, trench, or bore on the customer's property located at the above address for the installation of utility
service.
Prior to digging, trenching, or boring, the company will identify the route of the proposed excavation. The Company will notify other utility owners to
facilitate the marking of existing underground utilities, including electric telephone and cable TV.
The Customer agrees to physically mark the location of any and all customer owned obstacles that lie underground within ten feet of proposed excavation.
Such obstacles include, but are not limited to, septic and sewer systems, buried wires for out-buildings or decorative lighting, and LP gas lines. The
Customer shall mark the location of all of these obstacles with stakes or flags or by painting the ground. The Customer hereby accepts any and all
responsibility for damage to, or damage done by striking, any such underground obstacle the Customer fails to mark or marks incorrectly.
The Customer applies to the Company for service under rate schedule(s)
and requests that the Company extend its distribution facilities as necessary to provide such service in accordance with its rate schedules, rules and
regulations on file with the State Regulatory Authority. The Company agrees to furnish, and the Customer agrees to take and pay for utility service in
accordance with provisions and rates approved by the State Regulatory Authority; subject to all applicable rules of the Company on file with the State
Regulatory Authority including, but not limited to, terms and conditions stated above; until such time as the Customer discontinues service or elects to make
a written application for service under a different schedule. Such election, however, may not be exercised within a one-year period from the date of this
application. The persons signed below are jointly and separately liable for utility charges at the service address above. This agreement obligates the
Customer's heirs, successors and assignees.
APPROVAL AND ACCEPTANCE (I have read and understand the terms and conditions above)
Owner/Responsible Party Signature Owner/Responsible Party Printed Name Date