Generating Facility Pre-Application Request Form
Preamble and Instructions
An Interconnection Customer who requests a Pre-Application Report must submit this Pre-Application
Request by hand delivery, mail, e-mail, or fax to the Utility along with the non-refundable fee of
$500.
DISCLAIMER: Be aware that the Pre-Application Report is simply a snapshot in time and is nonbinding. System conditions can and do change frequently.

Check here if payment is enclosed. Fee is required for application to be considered complete.
Date: _____________________________
Interconnecting Customer Name (print): __ __________________ _______________________
Contact Person: ____________________ __________________ _______________________
Mailing Address: ________________________________________________________________
_____________________________________________________________________________
City: ____________________________ State: _________________ Zip Code: ___________________
Telephone (Daytime): ________________ ___ E-Mail Address: ________________________
Alternative Contact Information (e.g., system installation contractor or coordinating company)
Name (print): _______________________ __________________ _______________________
Role: _____________________________ __________________ _______________________
Contact Person: ____________________ __________________ _______________________
Mailing Address: ________________________________________________________________
_____________________________________________________________________________
City: ____________________________ State: _________________ Zip Code: ___________________
Telephone (Daytime): ________________ _____ E-Mail Address: ______________________
Facility Information:
1) Proposed Facility Location
Address (or cross-roads): __________ __________________ _______________________
City: ________________________________ State: ________ Zip Code: ______________________
 Site Map provided (Google, MapQuest, etc.)
 Grid Coordinates - Latitude: __________________________ Longitude: ____________________
 Pole or Tower number if available: _ __________________ _______________________
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2) Primary Energy Source
Choose one:
Renewable
1. Solar – Photovoltaic
2. Solar – thermal
3. Biomass – landfill gas
4. Biomass – manure digester gas
5. Biomass – directed biogas
6. Biomass – solid waste
7. Biomass – sewage digester gas
8. Biomass – wood
9. Biomass – other (specify below)
10. Hydro power – run of river
11. Hydro power - storage
12. Hydro power – tidal
13. Hydro power – wave
14. Wind
15. Geothermal
16. Other (specify below)
Non-Renewable
17. Fossil Fuel - Diesel
18. Fossil Fuel - Natural Gas (not
waste)
19. Fossil Fuel - Oil
20. Fossil Fuel – Coal
21. Fossil Fuel – Other (specify
below)
22. Other (specify below)
3) Prime Mover
Choose one:
1.
2.
3.
4.
Photovoltaic (PV)
Fuel Cell
Reciprocating Engine
Gas Turbine
5.
Steam Turbine
6.
Micro-turbine
Other, including Combined Heat and Power
(specify below)
4) Type of Generator
Choose one:
1.
2.
3.
Inverter-based Machine
Rotating Machine
Rotating Machine with Inverters
5) Size: ______________________ kW AC
6) Generator Configuration:
 Single-phase
 Three Phase
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7) Interconnection Configuration
 New Generation
 Stand-alone
 Addition to existing commercial or industrial customer’s delivery
Customer’s Electric Utility account number: _____________________________________
Customer’s Electric meter number: ____________________________________________
Is Customer’s kW load going to increase or decrease?
 No
 Yes, Details ____________________________________________________________
Proposed Point of Interconnection on Customer-side of Utility meter
________________________________ ____________________ __________________________
***OR***
 Addition to existing generation
 Stand-alone
 Addition to existing commercial or industrial customer’s delivery
Customer’s Electric Utility account number: _____________________________________
Customer’s Electric meter number: ____________________________________________
Is Customer’s kW load going to increase or decrease?
 No
 Yes, Details _______________________________________________________
Type of Existing Generation: ______________________________________________
Size of Existing Generation: ____________ kWAC
Proposed Point of Interconnection on Customer-side of Utility meter
_____________________________________________________________________________
Additional Comments
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
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