Individual Application - Trico Electric Co-Op

Comments

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

Date*

Trico Member Status*

New Member

Existing Member

Customer Number*

Billing Account Information

Primary Contact*

First Last

Social Security #

Date of Birth*

Driver's License Number*

Driver's License State*

Do you have a joint member?*

Yes

Joint Member

Name	Actions

There are no Members.

Home Phone*

Mobile Phone

Business Phone

Email*

Employer

Present mailing address*

Street Address Address Line 2 City State ZIP Code

Mailing address of new service (where you will receive the bill at the time of connection)*

Mailing address of new service is same as Present mailing address

Please note the billing account fees:

$250.00 Billing Deposit or Letter of Credit from present electric company. (See rule 124 & 128 of Trico’s current R,R,&LEP)
$100.00 New Service Establishment Fee plus applicable taxes will be billed on your first bill. (one time charge)
$20.00 per month, Fixed Monthly Charge plus applicable taxes, in accordance with Trico’s Residential (RS1) Rate Tariff.

(See rule 109, 139, & 140 of Trico’s current R,R,&LEP)

New Construction Information

Street address of new service*

Street Address Address Line 2 City State ZIP Code

Parcel ID or Subdivision (unit/block/lot)

Site Permit or Activity Number*

Agent/Company/Contractor Information

Name

Phone

Electrical Information:

Underground to meter

Overhead to meter

Underground to property line

Overhead to property line

Primary only (backbone)

Not sure

Service panel size or Meter pedestal size:

Load calculations required over 200 AMP

Volts:

House square feet:

Mobile/Manufactured Home square feet:

Well (HP of well pump(s):

Other (e.g. RV, Shop, Garage, Gate, etc.)

Will you have gas or propane on site?

Yes

Any life support equipment required?

Yes

What electric appliances will you have?

Date you will have all site improvements installed

Date you want service connected

Additional comments:

Please note the new construction fees:

Line Extension Costs all applicable fees (to be determined at a later date) shall be paid to the Cooperative, prior to construction. (See rule 203.D of Trico’s current R,R,&LEP)
A Design Deposit may be required to prepare detailed line extension plans. Such advance will be applied to the final cost. (See rule 201.B of Trico’s current R,R,&LEP)

Agreement to Accept Service

I have read and understand the requirements and my responsibilities regarding the type of service I am applying for, I also understand that I must meet those requirements before Trico can extend electric service to me.

By becoming a member of Trico, you agree to follow the policies, rules and schedules of Trico Electric Cooperative, Inc. A copy of the Rules, Regulations & Line Extension Policies approved by the Arizona Corporation Commission (ACC), 402 W. Congress, Tucson, AZ 85701, (520) 628-5555 is available on-line or upon request.

I hereby apply for electrical service at the above location. I understand that Trico will make service available upon completion of engineering details and duly executed contractual agreement between the parties. This application is valid for 60 days from the above date. I agree to accept service when construction is completed.

The design of your line extension will be based on the Rules, Regulations, and Line Extension Policies of Trico and must factor if existing facilities are capable and able of supplying your service requirement, plus responsibilities of the Cooperative and the Applicant, together with system plans of the Cooperative, to determine the most cost effective design, in the Cooperative’s opinion.

These instructions may not cover all situations. Some situations might require special written agreements or studies.

Applicant's Printed Name*

Date*

Applicant's Signature*

Additional Information

Trico’s Rules, Regulations, and Line Extension Policies can be found online here.

Trico’s Electric Service Requirements Book can be found online here.

Permits and Inspections from the Authority Having Jurisdiction (AHJ)

Mobile/Mfg. Homes require inspections from the County & State. (State Insp. currently only required in Pima Co. & City of Tucson)

Single Family Residences or Domestic Wells require inspections from the County/Town only.

*You are responsible for contacting the local AHJ to determine the proper permits and inspections required.

You may obtain a permit at one of the following agencies listed here.

Individual Service Application - No uploads

Billing Account Information

New Construction Information

Agent/Company/Contractor Information

Agreement to Accept Service

Additional Information