Elmhurst Mutual Power & Light > Plat Service Request Form

Plat Service Request Form

Name(Required)

First Last

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Plat Name(Required)

Lot Number(Required)

Service address (must match address with Pierce County)(Required)

Street Address Address Line 2 City State ZIP Code

Please Share Any Comments You Have:

Attach Site Plan(Required)

Max. file size: 20 MB.

I have reviewed the Elmhurst Mutual Power & Light Co.’s (Elmhurst) Service Handbook and understand its requirements as they relate to my request for a new electric service.
If I wish to proceed with the work after receiving the initial project cost estimate from Elmhurst, I will pay the project cost estimate to Elmhurst in accordance with the terms and conditions set forth herein.
If the project takes longer than 90 (ninety) days to complete (measured from the date Elmhurst provides me with the project cost estimate), then I shall be responsible for any increase in the cost to complete the project after said 90 days (this includes, without limitation, increases in material, supplies, labor, etc.). I further understand Elmhurst will stop performing work on the project until I have paid the balance of the cost increase in full.
I will also be responsible for unplanned associated costs incurred by Elmhurst in the completion of my project. Elmhurst will stop performing work on the project until I have paid the balance of any unplanned associated costs in full.
I understand that supply chain complications are beyond the scope of Elmhurst’s control. I acknowledge that even in communicating lead times of up to one year or longer for critical parts, Elmhurst has no control and accepts no liability of any kind for the actual production schedule or availability of any of the materials necessary for the completion of my electrical project.

Member Signature