Application for Electrical Service Form Applicants for all new or upgraded electrical services are required to submit this form prior to a service layout and Offer to Connect being completed. Delays in receiving necessary information may delay our ability to provide an Offer to Connect and service layout.NOTE: Depending on your address and the type of upgrade, you may not need a Technical Service Layout. Most subdivisions built since 2004 already have 200A services to the house.Before completing an application, please confirm that it is required for your location.Select the maps below. If you live on one of the streets highlighted on the map, you do not need to complete an application.Acton streets with 200A Supply Georgetown streets with 200A SupplyI have confirmed that my address is NOT listed on the maps. I require an Application for Electrical Service. * Required YES - I require an application NO – I do not require an application - Your address already has 200A service to the house. Have your electrician contact our Engineering Department at 519-853-3700 x213 to schedule a temporary disconnect/reconnect. By clicking NO you believe your residential service is already rated 200A. Please contact our Engineering Department at 519-853-3700 Ext. 213 to confirm.ApplicantName of ApplicantName of Applicant I am the (select one): * RequiredI am the (select one): Property Owner Tenant Property Manager Agent Company NameCompany Name Street Address Address Line 2 City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code PhoneFaxEmail Property Owner (If different from above)Full Name of OwnerFull Name of Owner Address Street Address Address Line 2 City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code PhoneFaxEmail Please specify to whom all communication should be sent: Owner Agent Location of LandAddress or locationAddress or location SERVICE INFORMATIONType of Service * Required Residential Commercial/Industrial Single Unit Multiple Units/Buildings Number of Buildings on Site For each building, indicate the number of residential suites, house services and commercial units Building 1 # of residential suites, house services and commercial unitsBuilding 2 # of residential suites, house services and commercial unitsBuilding 3 # of residential suites, house services and commercial unitsBuilding 4 # of residential suites, house services and commercial unitsAdditional BuildingsEstimated in Service Date - must be mm/dd/yyyy format(Note: If transformers are required for this project, the in Service Date must be a minimum six (6) months from the application date due to material ordering timelines. MM slash DD slash YYYY Estimated Monthly Peak Load (kW)Will the Service have an Electric Vehicle Charging Station? Yes No SERVICE CHARACTERISTICSType of Service * Required New service Service Upgrade Temporary Service For New or Temporary Services, please specify the Requested size (Amps)Amps 100A 200A 400A 1000A For Service Upgrades, please specify the upgrade requirementsAmps (from/to) 60-100A 100A-200A Voltage Requirements * RequiredVoltage Requirements 120/240V 120/208V 347/600V Service Main Fuse/ Trip Setting (Amps)Service Main Fuse/ Trip Setting (Amps)Proposed Location of Point of Supply * RequiredProposed Location of Point of Supply Proposed Location of the Electrical Room * RequiredProposed Location of the Electrical Room DRAWINGS INCLUDED Single Line Diagram Electrical Room Switchgear/ Main Switch CAD Civil Drawing Transformer/ Load Break Switch Drawings Drop files here or Select files Max. file size: 8 MB. FEES AND PAYMENTResidential Layout Fee: $341.54 Commercial/Industrial Layout Fee: $858.57 Please ensure you make payment of the layout fee using the following methods. Your application will not be processed until payment has been received. 1. Drop off cheque in mailbox; 2. Online credit card payment by clicking here. CUSTOMER SIGN-OFFI, the undersigned, understand that this application is subject to Halton Hills Hydro’s approval. I also understand that this application must be presented with civil drawings and electrical single line diagrams in order for HHHI to finalize electrical requirements. I further understand that in accordance with Section 6.1.1 of the Ontario Energy Board’s Distribution System Code, Halton Hills Hydro Inc. has up to 60 business days to complete an Offer to Connect and service layout once they have received the required information. I understand that any changes I make that causes Halton Hills Hydro Inc. to revise its work may result in the preparation of the Offer to Connect taking longer than 60 business days and that additional charges may be incurred. I agree to pay the layout fee set forth by Halton Hills Hydro Inc. as part of this application. Should I decide to proceed with the requested service after receiving a service layout and Offer to Connect, I agree to pay to Halton Hills Hydro Inc. all fees associated with the service layout prior to Halton Hills Hydro Inc. work commencement. I agree to pay for such service(s) as bills are rendered and agree to the Condition of Service as set forth above by Halton Hills Hydro Inc. To the best of my knowledge the information provided herein is accurate and reflective of the electrical service requested.Name * Required First Last Date - must be mm/dd/yyyy format * Required MM slash DD slash YYYY Agreement * Required I Agree