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Current
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Type of New Construction Service Needed
Checklist: The following must be submitted before application will be processed
Complete
Service Type
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New Facility
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If upgrading, what is your current Garkane account #
Applicant Information
Name
Email
Phone Number
Mailing Address
City/Town
State/Province
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Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
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District of Columbia
Federated States of Micronesia
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Pennsylvania
Puerto Rico
Rhode Island
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South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
SSN #(Last 4 digits only) or Tax ID#
Date of Birth
Service Address (Need physical address and lot/parcel #)
Service Address (Need physical address and lot/parcel #)
City/Town
State/Province
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Parcel #
County
Spouse or co-applicant
Contractor/Electrician Name, & Contact Info
Will temporary electric service be needed? (If yes, please refer to the New Construction Handbook for specs) *
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No
Yes
Anyone in your household on life support?
- None -
No
Yes
