FORM – Witwen – RUC LIghtSpeed

Date:

Property Owner Name: *

Mailing Address: *

City, State and Zip: *

Phone

Total Service Drop Fee: $100.00 (if received by August 1, 2023) *

Credit Card (Please note: RUC LightSpeed will need to set up your account to apply a credit card payment. If you choose this option you will be contacted by an Account Representative within 7 business days to apply your credit card payment)

Check (Mail to: PO Box 230, Reedsburg, WI 53959)

Checkboxes

I agree to supply a map to clearly identify all private facilities prior to start of construction activities. I understand that failure to supply this could result in damage to those facilities.

I understand that in the event of any damages to facilities that I did not indicate, Reedsburg Utility or it's contractor(s) are not responsible and I agree to hold them harmless for any damage.

I understand that a 120V outlet is required for the electronics and for service to be supplied.

Please Note:  A standard service drop includes vibratory plowing the service line from the road right-of-way to the customer premise.  Fiber service drop does not include private service extensions.  RUC / LightSpeed or it's contractor will contact Digger's Hotline prior to excavating on the premise.  Through Digger's Hotline, all public supply utilities will be marked from the right-of-way to the home or business.  Any private utilities such as water, sewer, irrigation, utilities to our buildings, LP Gas, water wells, septic lines, and wood furnace lines will not be marked.  RUC and it's contractor(s) are not responsible for damage to private utilities that have not been shown on the owner provided map/sketch prior to the start of work.  Turf restoration will only be completed on excavated turf areas in the right-of-way and not along the plow line or in the customers property.  Turf restoration will only include a rough backfill of material.  Standard installation fees may apply, additional fees may apply to non-standard installations.

Upload detailed sketch of your property here: (Please provide a detailed sketch of private underground facilities on your property such as: lawn sprinkler system, septic, well, gas, water, electric, and telephone lines, etc. )

Property Service Address (If different than above):

City, State, Zip

I accept and agree to the following terms:

Electronic Signature: Name: *

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