Line Move/Road Work Application Form

*Indicates a required field

Are you a consultant submitting this application on behalf of a customer?

YesNo

Consultant Information

Consultant Company Name

Consultant First Name:

Consultant Last Name

Phone Number:

Email Address:

Address:

Town/City:

Province:

Postal Code:

Customer/Company Information

Customer/Company Name:

Contact First Name:

Contact Last Name

Phone Number

Email Address:

Address:

Town/City:

Province:

Postal Code:

Required Service Information

Type of Service:

Road WorkLine MoveOther

Site ready for construction

Start Legal Location

End Legal Location

Customer Project Name:

Site Contact Name:

Site Contact Number:

Requested work completion date:

Please provide a detailed scope description of the work to be completed and how it could affect the distribution assets

Are there power facilities which need to be moved prior to customer work beginning?

YesNo

Are there power facilities which need to be moved during customer work?

YesNo

Additional Documents

Customers must provide a map and design plan with their application in order for an estimate to be prepared.

Maps

Design Plans

Submitting the following documents is not necessary to receive an estimate, however will help avoid delays in developing the preliminary estimate.

Photos

Survey Plan

Comments:

Please include any additional information about onsite generation or facilities at the location site that may not be included in the Survey or Plan plans and may affect the design or installation of the requested service. Please also note any known safety hazards on-site and any special permissions or requirements that ATCO Electric employees or contractors must obtain before accessing the site.

Contact Information