Franklin PUD

Billing Information

Customer*

First Name*

Middle Initial*

Last Name*

Service Address*

Apartment

City*

State*

Zip Code*

Please provide your Mailing Address below *only* if it differs from your Service Address.

Address

Apartment

City

State

Zip Code

Email Address*

Primary Phone*

Work Phone

Service Information (select applicable items)

Service is:*

Type of service:*

Type of structure:*

Load Information (select applicable items)

Voltage Desired:

Single Phase

120/240 volts, 3 wire (typical household)

Three-Phase

120/208 volts, 4 wire
277/480 volts, 4 wire

Size of meter base:*

100A
200A
320A
CT

Total service size (amps):*

No. of panels:*

Panel size (amps):*

Heating/Cooling:

Forced Air Electric (ton)

Air Conditioner (ton)

Heat Pump (ton)

Back-up Heat (KW)

Other (KW)

Not Applicable

Project Information

Electrician

Building Contractor

Site Information

Tax Parcel #

Block

Twp

Sec

Rng

Subdivision

Lot #

Are existing mainline facilities

Overhead
Underground