New or Upgrade Service 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:

New ExtensionTransformer Upgrade

Site ID:

Site ID is 13 characters in length

Estimate Type:

Ballpark EstimateFirm Proposal

Hidden Estimate

Firm Proposal

Date Service is required:

Customer Site Name:

Please provide information about previous or planned dealings with the affected land owner(s), including the number of land owners affected.

Load Type:

Supply Voltage:

Other Supply Voltage

Main Breaker Size (amps):

	New	Total
Peak Operating load (kW)		kW
Connected load (kW)		kW

	Existing	Incremental	Total
Operating load (kW)
Connected load (kW)

Future additions (kW):

Anticipated date of additions:

Service Location Information

LSD/Quarter

Section

Township

Range

Meridian

Subdivision/Area Name

State/Province

Mobile Power

Do you only need power to your site for a limited time? We offer a cost effective, reliable and sustainable temporary mobile power solution that gives your site power when you need it. Check this box if you want us to contact you with more information.

Contact Me

Motor Start Requirements

	VFD	Soft Start	Across the Line
Largest Motor by starting method (hp)

Desired Type of Electric Service

OverheadUnderground

Anticipated Service Life (years)

Required Site Information

Ready for a Site Visit

YesNo

Ready for Site Visit Date

Ready for Construction

YesNo

Ready for Construction

Site Contact Name:

Site Contact Phone Number:

Site Contact Email

Additional Documents

Customers are not required to provide a Survey Plan in order to receive a Ballpark Estimate, however providing this information in your application will help ATCO Electric prepare a more accurate Ballpark Estimate.

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.

Additional Documents

Customers must provide the following two documents with their application in order to receive a Firm Proposal.

Survey Plan

Plot Plan

Submitting these documents is not necessary to receive a Firm Proposal, however will help ATCO Electric provide a more accurate proposal.

Electric Drawings:

Load Profile:

Photos of site or access road:

Hazardous Area Specification Map:

Comments:

Contact Information