Application for New Electric Service

THIS IS NOT A PERMIT. Additional permits and inspections may be required and are the responsibility of the customer. ALL APPLICABLE FIELDS ARE REQUIRED.

This form is also available in PDF format here: New Electric Service

Construction Contractor Information

Billing Information

Service Location

Project Information 

Service Information

Estimated Load

I agree that the information on this application is correct to the best of my knowledge. I understand that any changes made to the above information or attached documents may increase the time and costs required for the Holland BPW to provide service to the project. I acknowledge that I understand and agree to the Terms and Conditions for Electric Service, available at hollandbpw.com.