APPLICATION FOR ELECTRIC,
ELECTRIC HEAT, STORMWATER, WATER OR SEWER
------------------------------------------

NAME __________________________________________________________________

City    Rural All Year    Rural Summer    Owner    Tenant     Guarantee

Service Connection Fee ________________________________________________

Deposit $___________   OR

Letter of Credit From: ________________________________________________

Address: ______________________________________________________________

I hereby make application for (electric, electric heat, stormwater,
water, sewer) service to the premises located at:

_______________________________________________________________________

In consideration for services rendered, I agree to pay the rates
established by the Public Utilities Commission of the City of Detroit
Lakes, promptly on or before the the due date of each month, and to
comply with all rules and regulations adopted by said commission. It
is understood that a discount on the gross amount (sales tax excluded)
will be allowed if bill is paid by the due date and service will be
disconnected if bill is not paid within 5 days after the due date.

____________________________
I, as owner or owners representative, guarantee payment by the
consumer, to the City of Detroit Lakes of any and all sums that may
become due to said City by reason of the above agreement.

Date _________________   Owner ________________________________________
  
Account No.____________________________________________________________

Mailing Address _______________________________________________________

_______________________________________________________________________

Former Residence ______________________________________________________

Occupation ____________________________________________________________

New Installation: Please Fill In
[  ]  Electric Heat
[  ]  Deep Freeze
[  ]  Dual-Heating - Type
[  ]  Dryer
[  ]  Stove
[  ]  Oil Burner
[  ]  Water Heater - Size
[  ]  Refrigerator

Home Phone ______________________  Work Phone _______________________