POWERPLUSWATERMARKOBJECT3 5 APPLICATION FOR NECESSARY WAYLEAVE THE ELECTRICITY ACT

1. Licence Holder's Details

2. Agent's Details (if applicable)

Principal Contact

Forename

Surname

Company Name

Building No./Name

Address Line 1

Address Line 2

Town/City

Postcode

Telephone

Mobile

Fax

E-mail

Ref No.

Forename

Surname

Company Name

Building No./Name

Address Line 1

Address Line 2

Town/City

Postcode

Telephone

Mobile

Fax

E-mail

Type of Licence

Does the Licence contain any restrictions on powers under Schedule 4 to the Electricity Act 1989 to apply for a necessary wayleave?

3. Landowner/Occupier Details

Please provide contact details for all owners and occupiers affected by the proposed necessary wayleave. These details will be used by the ECDU to notify parties of submission of the application.

4. Land to which Necessary Wayleave Application Relates (please include postcode)

5. Type of Application

Please select one of the following:

Installation of new electric line

Retention of existing electric line

6. Description of electric line to which application relates, including any limits of deviation sought (please continue on a separate sheet if necessary)

7A. Applications for new lines only

a) Date of service of Notice of request for wayleave on Landowner/Occupier

b) Date of expiration of period specified in the Notice

c) Has the landowner:

- Failed to give the wayleave before the date specified in 7A (b) above

or

- Given the wayleave subject to terms and conditions to which the licence holder objects

7B. Applications for retention of existing line only

a) Has the landowner/occupier given notice requiring the

licence holder to remove the existing line?

b) Date on which notice served

8. Pre-Application Discussion

Please provide details of pre-application discussions with landowners and/ or occupiers and how any concerns expressed have been reflected in the final proposals, using a separate sheet if necessary.

9. Related Applications

Please provide details of any related or linked applications for necessary wayleaves for the same line (use separate sheet if necessary).

Please provide details of any related consents or permissions for the scheme to which this application relates, for example any extant applications for planning permission or consent under section 37 of the Electricity Act 1989 or for planning permission under the Town and Country Planning (Scotland) Act 1997

10. Terms of Wayleave Sought

I

Yes

11. Duration of Wayleave Sought

Please specify the duration of wayleave sought and reason.

12. Application checklist

Wayleave Site Plan

13. Declaration

I, the applicant/agent confirm that the information given in this form is true and accurate to the best of my knowledge.

Signature: