Fillable Form 1.: CITY WATER, LIGHT & POWER ELECTRIC (City Water, Light, and Power)

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Form 1.: CITY WATER, LIGHT & POWER ELECTRIC (City Water, Light, and Power)

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File type: PDF

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INSTRUCTIONS: (FILL OUT A SEPARATE FORM FOR EACH SERVICE TYPE REQUIRED)
1.
2.
SERVICE TYPE:
TEMPORARY
( ≤ 200A, 120/240V, 1Ø)
PERMANENT
CHECK ONLY ONE SEE FOLLOWING SECTION
1 PHASE, 120/240V TEMPORARY SERVICE AMPS REQUIRED
(RETURN THIS FORM WITH THE APPLICABLE TEMPORARY HOOKUP FEE)
SECTION 1:
IF THIS IS A TEMPORARY SINGLE PHASE, 120/240V SERVICE @ 200 AMPS OR LESS, FILL OUT THE
AMPACITY REQUIREMENT LINE DIRECTLY BELOW AND "SECTION 1" OF THIS FORM ONLY.
This Area for TEMPORARY
( ≤ 200A, 120/240V, 1Ø)
SERVICES ONLY
TEMPORARY
SERVICE AREA
(≤ 200A )
TEMPORARY
(other)
CITY WATER, LIGHT & POWER
ELECTRIC ENGINEERING DEPARTMENT
1008 E. MILLER ST.
SPRINGFIELD, IL 62702
THIS FORM SHOULD BE COMPLETED FOR ALL NEW OR UPGRADE COMMERCIAL ELECTRIC SERVICES,
AND NEW OR UPGRADE RESIDENTIAL SERVICES 400 AMPS OR GREATER.
PANEL SCHEDULES SHOWING PERTINENT ELECTRIC LOAD DATA ARE PREFERRED. IF AVAILABLE,
SUBMIT ALL PANEL SCHEDULES AND THE ELECTRIC SERVICE ONE-LINE DRAWING. IF PANEL
SCHEDULES ARE SUBMITTED, SECTION 2 AND SECTION 3 OF THIS FORM DO NOT NEED COMPLETED.
PH: 217-757-8520 FAX: 217-789-2082
APPLICATION FOR RESIDENTIAL/COMMERCIAL ELECTRIC SERVICE
CUSTOMER INFORMATION
PROJECT NAME:
BILLING ADDRESS
(NAME & ADDRESS THAT SERVICE WILL BE BILLED TO):
NAME:
ADDRESS: APT./SUITE
CITY: STATE: ZIP:
SERVICE ADDRESS
(NAME & ADDRESS WHERE SERVICE IS REQUIRED):
NAME:
ADDRESS: APT./SUITE
CITY: STATE: ZIP:
CUSTOMER CONTACT:
CUSTOMER PHONE NUMBER(S): H/W: C:
DATE:
CUSTOMER
INFORMATION
Page 1 of 4
RESET FORM
Rev 3: 5/13/2011 RLM
ELECTRICAL CONTRACTOR or ENGINEERING FIRM:
NAME:
ADDRESS: APT./SUITE
CITY: STATE: ZIP:
CONTACT PERSON:
BUS PHONE: CELL PHONE:
E-MAIL:
DATA FURNISHED BY:
(PRINT NAME) (SIGNATURE)
SECTION 2: (See note 2 of instructions)
POWER:
1. Air Conditioning
# of
Units
Voltage
13
13
Equipment Function or Use
CWLP Use
Only
ELECTRIC LOAD REQUIREMENTS
Phase
Nameplate Rating
(HP, KW, Tons)
13
13
13
13
2.
Other Motor Load -
Total motor load in HP or KW with large and/or motors with special operating characteristics listed separately
# of
Units
Voltage
Soft / Reduced
Voltage Start
13
13
13
13
13
13
Equipment Function or Use
CWLP Use
Only
Phase
Nameplate Rating
(HP, KW, Tons)
Page 2 of 4
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3.
# of
Units
Voltage
Soft / Reduced
Voltage Start
13
13
13
13
13
13
4. Space Heating Equipment:
Is the primary heating source electric? Yes No
# of
Units
Voltage
13
13
13
13
SECTION 3: (See note 2 of instructions)
LIGHTING:
Interior Lighting Load (KW):
CWLP Use
Only
Equipment Function or UsePhase
CWLP Use
Only
Equipment Function or Use
Rated Load
(HP or KW)
Other Equipment -
Cooking equipment, water heaters, welders, rectifiers, heat treat, drying ovens, etc. - List equipment separately
in HP or KW
Phase
Rated Load
(HP or KW)
Interior
Lighting
Load
(KW):
Exterior Lighting Load (KW):
SECTION 4:
BUILDING SIZE:
Total Area of Building (Sq. Ft.)
Area Air Conditioned (Sq. Ft.)
Area Heated (Sq. Ft.)
Height of Ceiling (Ft.)
Total Lighting Load (KW):
(sum of interior & exterior)
Page 3 of 4
SECTION 5:
SERVICE INFORMATION:
1 Phase 120/240V 240/480V Other
3 Phase 208Y/120V 240∆/120V
480Y/277V 480∆VOther
Note: 3 Phase service or specified voltage may not be readily available.
Service Location: Overhead Underground
Main Breaker Size:
Amps
Size & Number of Service Conductors:
# of Sets # of Conductors per Set
Size of Phase Conductors Copper
Size of Neutral Conductor(s) Aluminum
Do You Prefer the Meter & Instrument Transformers on the Distribution Transformer? Yes No
Describe the preferred point of attachment on or at the building (attach site plan if available):
At CWLP discretion the electric meter and associated instrument transformers can be installed on the distribution
transformer in 3 phase applications serving only one load.
(Note: For 1 Phase services CWLP can accommodate a
maximum of (4) conductors per phase. For 3 Phase services
CWLP can accommodate a maximum of (6) or (10)
conductors per phase depending on the transformer size.)
Estimated Date Service Is Required:
Is electric the only source of energy used on the premises?
(Others may be gas, solar, wind, etc)
Yes No
Is a Generator Being Installed at this location? Yes No
Are any Renewable power sources being installed at this location? (Wind, Solar, etc.) Yes No
Do the Renewable power sources connect to the CWLP electric distribution grid? Yes No
If yes, fill out the "APPLICATION FOR INTERCONNECTION" and
"APPLICATION FOR NET METERING" forms and submit with this application
If yes, fill out the "CUSTOMER OWNED GENERATOR INFORMATION" form and
submit with this application.
Page 4 of 4
Submit this form to CWLP Electric Engineering:
E-Mail: eleceng.rep@cwlp.com
Fax: 217.789.2082
US Mail: CWLP Engineering
1008 E. Miller Street
Springfield, IL 62702
Questions: 217.321.1350
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Form 1.: CITY WATER, LIGHT & POWER ELECTRIC (City Water, Light, and Power)

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Completed 22 July 2021

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