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5. 
7. Request for Electrical Service (Residential)
   Please submit this form for each building to be served by Nephi City Power (NCP) for which you are preparing the electrical design specifications and plans. With this requested data, NCP will reply to you, giving the necessary electrical service information for you to complete your design. A digital copy of the site plan (showing proposed transformer location, meter base, and outside disconnect) and the electrical single line diagram is required. Please email to Rust Finlinson at rfinlinson@nephi.utah.gov or deliver to the address above. By signing this document, you hereby acknowledge that the information provided is accurate and take responsibility for this information up to and including financial cost for the replacement of NCP's equipment due to any inaccuracies contained herein.
9. Date
   Date
11. Project Name
12. Project Location*
14. Your Name
16. Company Name
18. Address
20. City
21. State
22. Zip Code
24. Contact Person*
25. Phone Number*
27. Email Address*
28. Sq. Ft.
30. Anticipated date for permanent electric service:
32. Service Desired from Nephi City Power
34. Delivery Voltage: 240/120 1-Phase
35. Customer Electric Panel Size (Amps):
36. Conductor Size
38. Conduit Size
39. Number of Conduits
40. Secondary Service
    -- Select One --UndergroundOverhead
42. Digital copy of site plan & the electrical single line diagram
44. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
46. Electronic Signature*
48. To be completed by Nephi City Power Department
50. The meter base for this installation is to be located on the ______________ side of the building.
52. Service will be provided from __________________________________________
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field