No Application of Herbicide | Polk-Burnett Electric Cooperative

No Application of Herbicide

NOTE, IT IS NOT NECESSARY TO COMPLETE THIS FORM OR CONTACT US IF:

1) You are served by underground power lines. Polk-Burnett does not apply herbicide to underground lines.

2) You have already sent this form or contacted Polk-Burnett in the past to decline the use of herbicide. The list can be checked here.

Name

First Name

Last Name

Location Information

Location Information
Polk Burnett Location Number or Account Number Parcel ID Number From County Tax Record Property Address (if applicable)

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Please do not apply herbicide on my property(s).

I understand that if I have multiple properties where I do not want herbicide application to occur I must notify Polk-Burnett of those locations as well, so they can be properly identified. I further understand that I must place signs (provided by Polk-Burnett upon request) beneath the power lines to identify my property boundaries and that future right-of-way maintenance will be performed by means of mowing.

If your request is received after herbicide application, the change will apply for future right-of-way maintenance.

Phone Number

Email Address

Signature

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