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Service for New Construction

Please fill in the form below to apply for electric service to a new location. Firelands' staking engineer will meet with you at your building site to discuss your power requirements and plans, and help you complete an easement and other paper work so we can schedule crews to build your service lines.

Firelands Electric will reply via e-mail to confirm your request for service. Our representative will call to arrange a field appointment at your site.

A deposit and/or construction fees may be required for your new service. Our staking engineer will explain all fees that may apply. All fees must be paid and all paperwork completed prior to scheduling construction work.

* = Required Information.

Name: *
Last 4 digits of SSN:
Employer:
Additional Name:
Additional SSN:
Mailing Address: *
City: *
State: *
Zip: *
Home Phone: *
Work Phone: *
E-mail
Emergency Contact
Name: *
Address: *
Phone: *
Type of Service
Type: *
Own/Rent Home: *
If Business, Federal Tax ID#
Service Address
Requested Date for Turn-On: (MM/DD/YYYY)
Service Address: *
City: *
State: *
Zip: *
Heat Type/Source: *
A/C: *
Range: *
Dryer:
Water Heater: *
Refrigerator:
Freezer:
Dehumidifier:
Dishwasher:
Water Bed:
Pool:
Additional Information
Comments:


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