HomeMy WebLinkAboutCL&P Disconnect for Demo
APR-22-2003 TUE 03:01 PM CUP WATERFORD FAX NO, 860 447 5755 P. 02
03
4
FCC;LF-,ARING 20
man 'Tcv Conne ucut L igbt & Power Co- ~i~S
P.O. Box 2985
Hariford, CT. 06104-?983
of Sal ce for BtM4ldins PttMn itian
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As the own€~ r Qfi this property's am m oestiniktm 'pe'~mmi)t ~aKrr peat of t I%- exisJSr+r3 CT Li, t & Paver Company
(CLU) electric service and meter(s) to allow for the demolition of the building in accordance with all applicable
Connecticut General statutes, I certify that the building is vacant
oxstam -w tSystena (CRS trading number
I- tl'
Strut Address whcre electric scrv a is to Ira permM tty rtn aved.
Town, Stale and Zip-Gc4e
L3~ a
Meter fiber (s)
14
Welcr number (s)
Conuntnt3:
a x`mt n ai Pra?.~tY orv~~c: r'~. s 1~ra ~ i?
Signature of pr+SpeYty owncx:.1 ~P.~.}~i•- V ~ 1AA~~'•~-
Mailing Address:
.r VERY.,Tltt~
= foivri;stay Sig 11.: A~~ Rte! ' / sr NOTARY P'VSLJC
L't}fv4Ml..~iDli i 7t~'tA 3 MAY 3L 20A,0
=Tr etMite Nuii" cr . own=
t' J
Date
:1~rataM'y~'blic~
LJ-Aixr is eras u only
E>4ta sers~e reM,9Ved: f L. Please add aaob note to CRS indicating the date and to whom this
signed-ot'f foam was rewrned, file completed form with the completed service removal work order.
1~f
Print nMSrne ofC:L&P Representative:
SiVature of CL&P Representative: _
ty',Q_ L
Telephone ttiUrttiber: Date: f
_
Tcr Ay-old Deters Please Complete All Information On The Form