Basic design application

Please note this form was previously referred to as a Request for Service Marking (RSM).

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*Denotes mandatory field

Contact details

Name *

Phone *

Email *

Contact type *

Electrical contractor

Builder

Home owner

Other

Location details

Block *

Section *

Suburb *

Street address *

Request details

Required works *

Reason for request *

Site visits required *
If you are unsure of the number of site visits you require please consult your licenced electrician 1 site visit 2 site visits (same day) 2 site visits (different days)

Time frame between site visits (days/weeks/months) *

Load requirements

Calculated maximum demand (amps per phase)

Consumer mains size (mm)

Applicant declaration

Subject to and in accordance with the National Electricity Rules, I understand and agree that by signing below and submitting this application to Evoenergy:

I am submitting a Basic Design Application for connection or alteration to Evoenergy’s electricity network for Basic Connection Services.
I agree to pay the relevant design fee as particularised in Evoenergy’s Schedule of Electricity Network Charges. The fee shall be invoiced and I understand that I am liable to pay, regardless of whether I progress with the connection or alteration beyond the design.
Any confidential information of Evoenergy disclosed during the course of negotiations must be kept confidential.
This form does not constitute an offer and does not commit Evoenergy to providing any goods or services.
I warrant that I am authorised to execute this application on behalf of the connection applicant.
Being duly authorised, I approve access at the property for which the work has been requested, for Evoenergy and any required contractors appointed by Evoenergy to complete the requested works.

Name *

Date