New Construction Application

Application for Electric Service

Service Contract with ALP Utilities, City of Alexandria, Minnesota

The undersigned (hereinafter called the Applicant) hereby applies for electric service from ALP Utilities, the City
of Alexandria’s municipally owned electric utility (hereinafter called ALP). The applicant and ALP agree to the
following:

1. When ALP makes electrical service available to the applicant, the applicant agrees to purchase from
   ALP and pay monthly to ALP for all electric energy or the demand and energy used at the location
   described below (hereinafter referred to as property). The applicant will pay according to the rate
   schedule and rules and regulations established by ALP.
2. The applicant hereby grants to ALP the right and easement to construct, operate, repair and maintain
   underground and overhead service lines and electrical distribution appliances on the property and
   upon all streets, roads and highways abutting said Property. The applicant grants ALP the right to cut
   or trim trees where necessary to clear all parts of the electric system.
3. The applicant agrees to comply with all laws of the State of Minnesota regulating the installation of
   electrical wiring and equipment and all rules and regulations as adopted by the State Board of
   Electricity and by ALP.
4. The applicant hereby releases ALP and its employees from any and all liability of every kind and
   nature for damage which may occur from defective wiring at the Property or from failure to inspect said
   wiring and does hereby agree to hold ALP and its employees harmless from any and all such liability.
5. ALP requires that all electric dual fuel and/or storage heating services must be formally applied for on
   application forms supplied by ALP with review of details and approval required before installation and
   connection. This regulation applies to all services, new or existing.
6. The applicant will comply with and be bound by such rules and regulations as may be adopted by ALP
   from time to time.

The acceptance of this application by ALP shall constitute an agreement between the applicant and ALP and
the contract will remain in force until cancelled by written notice.

Applicant's Information

Applicant's Name(Required)

First Last

Contact Phone(Required)

Email(Required)

Mailing Address(Required)

Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code

New Service Location Information

New Service Address(Required)

Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Zip

Parcel Number

Approximate Date Service Required(Required)

Month

Day

Year

Building Type(Required)

Residential

Residential Multiple Unit

Commercial

Industrial

Type of Service(Required)

Temporary

Permanent

Heat Source(Required)

All Electric

Electric & Gas

All Gas

Other

Electrician's Name(Required)

First Last

Applicant's Signature(Required)

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