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Form for Franchise Utility Work

2. Notice
   This page is intended for Franchise Utilities to communicate with the City of Midland about where and when they will be doing work within the city limits. If you need to file a request with a Franchise Utility, please contact them directly for assistance.

   This page is intended for Franchise Utilities to communicate with the City of Midland about where and when they will be doing work within the city limits. If you need to file a request with a Franchise Utility, please contact them directly for assistance.

6. Franchise*
   -- Select One --ONCOR Electric DeliveryAT&TSharyland UtilitiesAtmos EnergySuddenlink CommunicationsGrande Communications

   Please select the company you work for.

8. Anticipated Date of Work

   Month and year only

10. Will the Work Take Place in a Street or Alley?*

    1. Street
    2. Alley

12. Street or Block Number*

13. Street Name*

15. Block Number*

16. Street Name*

17. Even or Odd Side?*

    1. Even
    2. Odd

19. Type of Work to be Performed*

    1. Aerial
    2. Trenching
    3. Boring
    4. Other

21. Type of Work*

25. Contractor Information

27. Company*

29. Contact Name*

30. Contact Phone Number*

32. Additional Information

Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print

* indicates a required field