note1 Please do not complete this form if you are Moving. Please visit our Moving Page for Moving Information. Date Service Address Meter # (Include All Zeros) Hydro Account # Owner Name Owner Address Email Owner Telephone Number (Complete With Extension) As owner of the above mentioned property, I hereby authorize Niagara Peninsula Energy Inc. to disconnect and remove all hydro owned equipment service for demolition at the above mentioned property effective from: Effective Date Reason Demolition Other Explain Reason I agree to hold Niagara Peninsula Energy Inc. harmless for any damages that may occur as a result of discontinuing the supply of electricity. Owner Name for Authorization Date Owner's Signature (Sign By Typing Your Name) **Owner/Contractor is responsible for ensuring service has been disconnected prior to demolition.** *PLEASE NOTE: ANY PROPERTY THAT HAS BEEN DISCONNECTED FOR A PERIOD OF SIX (6) MONTHS OR LONGER REQUIRES AN INSPECTION PERMIT TO BE RECONNECTED.
