HomeMy WebLinkAboutBLOOM FILING FOUR - FDP240001 - SUBMITTAL DOCUMENTS - ROUND 2 - Supporting Documentation (3) WORD\DATA\FORMS\C-1.DOC REV.August 14, 2020
CUSTOMER OWNED SERVICE INFORMATION FORM (C-1)
City of Ft. Collins Electric Utility 700 Wood St. P.O. Box 580 Ft. Collins, CO 80522
(970)221-6700 or fax (970)221-6619
Service voltages available are (not all voltages are available at all locations):
120/240 V. 1 phase, 3 wire 120/208 V. 3 phase, 4 wire
120/208 V. 1 phase, 3 wire (network) 277/480 V. 3 phase, 4 wire
Primary 13,200 V. Grd Y /7620 120/240 V. 3 phase, 4 wire (special utility permission required)
For CT’d meters, Light and Power will provide the meter socket and CT’s to the electrical contractor. CT’s cannot be
placed in the transformer, but may be located in a building mounted cabinet (provided by owner) or in the owner’s
switchgear. In no case, can meters be mounted on the transformer.
· Cold sequencing is required for all commercial services that are direct metered.
· If CT’d metering, the owner must provide and install a - 1” conduit from the CT location to the electric meter.
Please complete the following completely and legibly:
Date Submitted: _____________________________________
Voltage Requested: _____/_____ 1 phase OR 3 phase
Building Main (not fuse) Size: ____________________ Amps
Number of Conduits: _______ Size of Conduits:_________
Number of Cables: ________ Size of Cables: ___________
Electric Heat: Yes _________kW No
Business Name: ____________________________________
Site Address: ______________________________________
Owners Name: _____________________________________
Mail Address: ______________________________________
City: ______________________________________________
State & Zip: ________________________________________
Phone: ____________________________________________
Email: ____________________________________________
General Contractor: _________________________________
Individual: _________________________________________
Mail Address: ______________________________________
City: ______________________________________________
State & Zip: ________________________________________
Phone: ____________________________________________
Email: ____________________________________________
Electrical Contractor: ________________________________
Mail Address: ______________________________________
City: ______________________________________________
State & Zip: ________________________________________
Phone: ____________________________________________
Firm: ______________________________________________
Email: _____________________________________________
Number of CT’d meters: __________ at ___________Amps each
Number of Self-Contained meters: _____ at ________Amps each
Largest Motor: ________ H.P. 1 Phase __________ H.P. 3 Phase
Will any generating system (including photo-voltaics) be installed?
Yes (contact utility for requirements) No
If Yes, this will be for: emergency service
parallel generation
Will a fire pump be installed? Yes No
Form Completed by:
Name: ________________________________________________
Company:_____________________________________________
Mail Address: _________________________________________
City: _________________________________________________
State & Zip: ___________________________________________
Phone: _______________________________________________
Email: ________________________________________________
For Office Use Only
Transformer Size: _________________________________kVA
Fault Current at Transformer: _______________________Amps
100% Construction - Cont. # ____________ Paid: ____________
A.T.E. Date: _____________________
Engineering Approval by: ______________ Date: _____________
Metering Approval by: _________________ Date: _____________