Pole Attachment Application

Please complete the below form to apply for pole attachment to Cloverland Electric Cooperative utility poles. Form can also be found at the link below and submitted via the instructions on the form. Incomplete applications or applications without application fee paid will not be reviewed.

Please complete the following form to apply for pole attachment

"*" indicates required fields

Organization Name*

# Pole Attachments Needed*

Town of Attachment*

County*

Nearest Cross Streets*

Physical Properties of Attachment*

New Install

Over Lash

Attachment Type*

Method of Attachment*

Finished Diameter (inches)*

Finished Weight (lbs./ft.)*

Installed Tension (lbs.)*

Tentative Start Date*

Application Completed By:*

First Last

Title

Billing Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Date*

Design Packet Upload (If Applicable)

Max. file size: 100 MB.

For 10 or more pole attachments, a design packet is required