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CITY WATER, LIGHT & POWER ELECTRIC ENGINEERING DEPARTMENT (City Water, Light, and Power)

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CITY WATER, LIGHT & POWER
ELECTRIC ENGINEERING DEPARTMENT
1008 E. MILLER ST
SPRINGFIELD, IL 62702
PH: (217) 757-8520 FAX: (217) 789-2082
RESIDENTIAL ELECTRIC VEHICLE CHARGING SERVICE
INSTRUCTIONS
Complete this form for all new or upgraded residential services for the installation of Level 2 electric
vehicle chargers.
CUSTOMER INFORMATION
Name: ___________________________________________________________________________
Address: _________________________________________________________________________
City:_________________________ Zip Code:____________________ PH:____________________
Email:______________________________________________________________
EV CHARGER INFORMATION
Manufacturer(s):__________________________________________________________________
Nameplate Amps: ______________ Required Voltage: ____________
INSTALLATION INFORMATION
Scheduled Install Date: _________________ Total Number of Chargers Installed: ____________
Electrical Contractor: _______________________ Contact Person: __________________________
PH: ___________________________ Email:____________________________________________
Email: ElecEng.rep@CWLP.com
Fax: 217.789.2082
US Mail: CWLP Engineering
1008 E. Miller Street
Springfield, IL 62702
Phone: 217.321.1350
240
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CITY WATER, LIGHT & POWER ELECTRIC ENGINEERING DEPARTMENT (City Water, Light, and Power)

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Completed 22 July 2021

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