First Name Please enter a value. Please enter a first name.

Last Name Please enter a value. Please enter a last name.

Billing Address Please enter a value. Please enter a value.

Site Address Please enter a value. Please enter a value.

Do you have Duke Energy owned poles? Yes or No Please enter a value. Please enter a value.

Attachment type? (cameras, antennas, etc.) Please enter a value. Please enter a value.

Attachment dimensions Please enter a value. Please enter a value.

Does the attachment need a power source provided by Duke Energy? Yes or No Please enter a value. Please enter a value.

If not 'Yes' above, where will the attachment receive power from? Please enter your comments Please enter your comments.

To process your request faster, please send a photo of the pole(s) you wish to attach to OLRequests@duke-energy.com along with the site address provided in this form.