Miscellaneous Engineering Inquiry Application

Phone

This field is for validation purposes and should be left unchanged.

A $75 application fee is required when submitting a new construction application to KV REMC.

Name(Required)

First Last

Phone(Required)

Email(Required)

Meter Number(Required)

Pole Number

Service Address(Required)

Street Address Address Line 2 City State ZIP Code

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Inquiry Type

Disconnect/Reconnect

Security Lights

Service Retirement

Work Order Status

Blinks/ Outages

Joint Use/ Pole Attachment

Rates

Contractor

Other

Will the security light be on an existing pole?

Yes

No

Pole number where light will be installed .

Notes

Consent(Required)

I hereby verify the information to be true and complete. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.

Fee(Required)

I understand that I am required to pay a $75 application fee. An engineer will only review your application once the payment is made. Only cash, check or money orders are allowed as payment.

Applicant Electronic Signature (Full Name)(Required)