Please read and complete all sections on this form. We cannot move forward until all items are received.
We require a $100 non-refundable staking and engineering fee to assess the project. Once we receive payment, we will contact you to schedule an appointment for a Line Design Technician to visit your property. Following the visit from the technician, you will receive an invoice for the full cost of the project.
If you are attending the appointment, we will also bring your right-of-way easement form. If your contractor will attend the meeting on your behalf, we will send the easement with your invoice.
Please note: your invoice needs to be paid and the easement needs to be returned to our office prior to the start of construction.
The undersigned hereby applies for electric service from MIDWEST ENERGY & COMMUNICATIONS (MEC) and in consideration of the acceptance of this application agrees with MEC on the following:
MEC is committed to completing your project in a timely and professional manner. However, member-owned underground facilities are not marked or protected by Miss Dig, so we must have the signed Hold Harmless Agreement before we proceed. Also, despite our most diligent efforts, ruts or other cosmetic property damage may result as we move vehicles or equipment onto your property. The agreement is limited to the service location and expires upon completion of this project or removal of facilities.
I agree that MEC is not responsible for damage to any unmarked, member-owned underground facilities as it relates to work at the service location. This includes secondary electric, water, phone, gas, septic, well head and any other underground facilities. I further agree that MEC is not responsible for yard or property damage incurred as a result of accessing property for this project.
In order to provide timely and effective communication, we need your primary phone number and ask that you authorize us to use that number to deliver important account-related information.
I hereby authorize MEC to deliver planned outage notifications, delinquent account/disconnect notices, billing notices, right-of-way tree-clearing notifications using an automatic telephone system, artificial or prerecorded voice, text message or other form of written or audible communication via the phone number provided in this form.
Use your mouse to draw your building site.
Show location of ALL facilities (septic, water, gas, cable, etc.), nearest pole #, driveway and location of meter base.
* Required: if unsure please place N/A in the answer.
Please go back through the steps and make sure you have completed all the required fields.