Job Number* Do you have any safety concerns relating to your site?* Yes No If you have safety concerns please provide detail below. Do you require planning permission for any development work that you are undertaking on your site?* Yes No If yes have you obtained the relevant planning permission at this stage? Yes No Do you require a budget quotation only at this stage? A budget quotation is based on a high level assessment of the costs involved. A budget quotation is not a formal connection offer and you will not be able to accept this as an official quotation from us. Please note that the budget estimated costs may vary from a formal connection offer* Yes No Have you started any site works yet?* Yes No If yes please provide details on what stage your site works are at present When do you require the electricity connection/alteration works to be completed?*