APPLICATION
COLORADO
Application For Gas And Electric Services
Please photocopy both sides of this page for multiple use.
DATE
BCLCO@xcelenergy.com
PHONE: 1-800-628-2121 FAX: 1-800-628-2521
SERVICE ADDRESS (PLEASE PRINT)
House or Fire Number Full Street Name
City State Zip
Urban
Subdivision Name
__________________________
Lot Number _______________________________
Block Number _____________________________
County ___________________________________
Rural
County
____________________
Township
_________________
Range ____________________
Section ___________________
Direction to service location (Rural required)
________________________________________
________________________________________
________________________________________
________________________________________
Unincorporated Incorporated
Cross Street/Road
CONSTRUCTION INFORMATION (PLEASE PRINT)
Owner Information (Party to be billed during construction)
Owner/Builder Name
___________________________________
Mailing Address _________________________________________
City _____________________________State ____ Zip _________
Phone Number __________________________________________
Contact during construction _________________________________
Address _______________________________________________
City _____________________________State ____ Zip _________
Email _________________________________________________
Daytime phone __________________________________________
Fax __________________________________________________
Cell __________________________________________________
Contractor Information (include phone number)
Builder
_______________________________________________
Phone Number __________________________________________
Email _________________________________________________
Heating Contractor _____________________________________
Phone Number __________________________________________
Email _________________________________________________
Electrical Contractor ____________________________________
Phone Number __________________________________________
Email _________________________________________________
A & E Firm ____________________________________________
Phone Number __________________________________________
Email _________________________________________________
Required services: Electric Gas New Relocate Conversion Demolition
SERVICE INFORMATION (COMPLETE ALL SECTIONS)
Electric Service
overhead underground Service size (amps) ____________
Air conditioning tonnage: ____________ ton
single phase three phase Voltage ___________________
Is temporary electric service needed? Yes
single phase three phase at pole
at transformer pedestal other __________________
Date needed_______________ /_______________ /20_____
Foundation backll / To grade___________ /___________ /20 ______
Gas Service (For gas service, please ll out second page of application.)
Is this service being used for primary heat? Yes No
Total gas load (BTUs/hour):
_______________________________
Pressure 6 or 7 inch 2 lb Other __________________
Date needed ____________ /____________ /20_______
Foundation backll / To grade ___________ /_________ /20 _______
FACILITY INFORMATION (COMPLETE ALL SECTIONS)
Building Type
single home duplex multi-dwelling/no. of units _____________________ commercial bldg. mobile
Building Class
residential commercial farm
Building square footage
___________________________ Building setback from property line (feet) __________________________________
Electric Meter location preference (when you are facing the front of the house from the outside) on house
on garage
right side left side front other ___________ Feet from front corner __________________________________
Gas Meter location preference (when you are facing the front of the house from the outside) on house on garage
right side left side front other ___________ Feet from front corner __________________________________
For Commercial
Total motor load_________ HP _________ Largest HP _________ Code___________ BTU input ___________
See second page of form
xcelenergy.com | © 2014 Xcel Energy Inc. | Xcel Energy is a registered trademark of Xcel Energy Inc. | Public Service Company of Colorado, an Xcel Energy Company. | 14-03-307 03/2014
END USES
Equipment type Gas (specify BTUs/hours input) Electric (specify kW) Other Fuel Type
Heating
Water heating
Cooking
Air conditioning
Clothes drying
Fireplace
Lighting (Commercial Only)
Heat source
(check type) Forced air furnace Heat storage Underoor/slab heat Baseboard
Meter Option (if applicable) Time of use Dual fuel Limited off-peak Saver’s Switch
It is preferred that the site plan including proposed meter locations and compass directions be attached. Or draw
sketch below as if you are facing the front of the house from the outside.
Service Address
______________________________________________________________________
Please
indicate
north
GAS AND ELECTRIC SERVICES APPLICATION
COLORADO
Meter Conict Zone
X
Garage House
2nd Street
Contact: Builders Call Line
Xcel Energy
Phone: 1-800-628-2121
Fax: 1-800-628-2521
BCLCO@xcelenergy.com
1. Customer-owned facilities must be located and identied
by customer.
2.
Indicate distances for meters from nearest corner of building.
3. Preferred meter location is on same side of house as
Xcel Energy source.
4. Inspection must be complete before service is energized.
5.
If no Inspector, Proof of Compliance (Electric) and/or
Certicate of Compliance (Gas) must be complete.
6.
Site must be within 4 to 6 inches of nal grade (for new
construction) and a clear 10-foot-wide path from Xcel Energy
source to meter.
7. Winter construction charges may apply from 10/1 to 4/15.
8.
Water and sewer must be installed prior to electric or
gas service.
Meter Conict Zone any potential area for a deck, patio, pool, etc.
Gas Meter
(note distance)
15’
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