C&L Electric Cooperative

Please complete the form below. You also have the option of downloading a PDF version of the form instead.

PLEASE NOTE: FAILURE TO MARK OR EXPOSE CUSTOMER’S UNDERGROUND FACILITIES RELINQUISHES C&L ELECTRIC COOPERATIVE FROM LIABILITY AND RESPONSIBILITY TO REPAIR ANY DAMAGES DONE DURING CONSTRUCTION.

Consumer check list for proposed service upgrade and new service installation.

Please check all that pertains to you and your property.*

Septic Tank

Gas Line

Telephone Line

Water Line

Leach Bed

Water Well

Cable or Satellite TV

Sprinkler System

Any other objects below ground level

Please Specify

If other objects below ground level please list below

AGREEMENT FOR RIGHT -OF-WAY TRIMMING ON CUSTOMER’S PROPERTY

I agree to have C&L Electric Cooperative cut or trim tree/trees on my property as explained and agreed to and not hold the Cooperative liable for any damages on my property. I also understand that the clean up of all debris is my responsibility, unless otherwise noted. I also agree if any RUTS are made from heavy trucks and equipment that I am responsible for having them fixed.

Member Name*

Address*

Phone Number*