| Service Type: |
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| New Line Type
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| Service Voltage |
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| Service Type |
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| Meter Location or Building |
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| Responsible Party to Pay Cost Incurred: |
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| If you answered other please explain |
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| Billing to be Set Up for: |
| Name |
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| Address |
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| Phone # |
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Installation will be completed when Bluewater Power receives by Fax the Connection Authorization From ESA.
For Electrical Inspection Contact ESA @ 1-877-372-7233.
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