Form A/01: Pre-Applicationenquiryinrelationtoanew connectionorconnections

For use by Retailers or Non-Household Customers

Pleaseremembertoincludeyourapplicationfee£155.00 + VAT (£186) whensubmittingthis applicationform.

To Water Wholesaler......

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To Sewerage Wholesaler......

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ThisformshouldbeusedwhereanyNon-HouseholdCustomerenquiresoftheWholesalerasto theprovisionofWaterorSewerageServicesforaproposeddevelopmentorpremisesunder Process A1 oftheOperational Terms, wheretheNon-Household Customerhas selected aRetailer.

The form is divided into sections as follows:

Number / Section
1. / Retailerdetails
2. / Developmentdetails
3. / Planninginformation
4. / Siteservicingdetails
5. / Specialrequirements
6. / Declaration

Sectionsmarkedwithanasterisk(*)aremandatory.

Mandatorymeansthatthe Retailermustprovidethe requestedinformationwhereveritappliesto theparticularrequest.Ifapieceofinformationdoesnotexistoris notapplicableinthe circumstances,theRetailermustnotethisand,where relevant,providea reasonwhyitisnot applicable.

  1. Retailer details

Retailer Name......
Retailer ID......
Retailers own reference......
Contact Name......
Contact number......
Contact e-mail......
  1. *Development Details

Pleaseindicatethetypeofdevelopment
☐ Industrial
☐ Commercial
☐ School
☐ Hospital
☐ Hotel
☐ Other
If Other, please state type of development ......
Numberofunits
☐ Commercial......
☐ Industrial......
Area of site (ha)......
Please advise start date of development ......
PleaseprovideanyWholesalerreference(s)previouslygiventothesite
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Site or project name......
Site address......
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Ordnance Survey references at centre of site (10 fig)
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Location of Development......
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Postcode (i.e. first 2-4 alpha-numeric characters)
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Name of Developer......
Name of site contact......
Contact number......
Contact email......
  1. *Planning information

In which local authority area will the development be constructed?
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(i)Is the development included in the local plan?
☐ Yes☐ No
(ii)Has the outline planning permission been granted?
☐ Yes☐ No
(iii)Has detailed planning permission been granted?
☐ Yes☐ No
(iv)If relevant, date detailed planning permission received
......
(v)If either outline or detailed planning permission received, please provide the planning reference number
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  1. *Site servicing details

Thefollowinginformationisusedtoassesstheimpactofthe developmentonthe Wholesaler's existingNetwork.
Completelandtypeandsection4.1forallapplications.
Completesection4.2forapplicationstoWater Wholesaler.
Completesections4.3to4.6forapplicationstoSewerageWholesaler
Land type for this development
☐ Greenfield
☐ Brownfield
Pleasecompletetheadditionalfieldsmarkedwithanasterisk(*)if thesiteisabrownfield development
*Previoususeofsite......
*Date previousbuildingwaslastoccupied......

4.1 Development Levels

Whatisthelowestgroundlevelonsite (toordnancedatum in metres)?......
Whatisthelowestroadlevelonsite (toordnancedatum in metres)?......
Whatisthelowestroadlevelonsite (toordnancedatum in metres)?......
If your site is identified as being constrained, please tick the box to indicate if you wish to receive a quotation for the necessary investigation work.
☐ Yes
☐ No

4.2 Water Details

Pre-developmentpeak waterdemand (in litres per second)......
Pre- developmentaveragewaterdemand (in litres per second)......
Post-developmentpeak waterdemand (in litres per second)......
Post-developmentaveragewaterdemand (in litres per second)......
Proposed highest water fitting on site (to ordnance datum in metres)......

4.3 Sewerage Details

Pre-developmentwastewaterdesign(please tickoneofthefollowingboxes).
☐ TotallyseparateFoulSewageandSurfaceWater
☐ Combined
☐ Partially Combined
If partiallycombinedor combined,please indicatequantity ofSurfaceWaterdrainingtocombinedsystem (in litres per second)
......
Pre-development peak foul discharge (in litres per second)......
Pre-developmentaverage foul discharge (in litres per second)......
Post-developmentwastewaterdesign(please tickoneofthe followingboxes).
☐ TotallyseparateFoulSewageandSurfaceWater
☐ Combined
☐ Partially Combined
If partiallycombinedor combined,please indicatequantity ofSurfaceWaterdrainingtocombinedsystem (in litres per second)
......
Post-development peak foul discharge (in litres per second)......
Post-development average foul discharge (in litres per second)......

4.4 Surface Water Drainage

Pre-development Surface Water discharge (in litres per second)
Please indicate where the Surface Water is currently discharging.
☐ SurfaceWater sewers
☐ Combined sewer
☐ Soak-away
☐ Direct to watercourse
Please specify
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☐ Rain water harvesting
If Rain water harvesting please indicate the approach used
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Any other relevant information
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☐ Other
Please specify
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Post-developmentpre-attenuated Surface Water discharge (litres/second)......
Post-developmentattenuated Surface Water discharge(litres/second)......
☐ SurfaceWater sewers
☐ Combined sewer
☐ Soak-away
☐ Direct to watercourse
Please specify
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☐ Rain water harvesting
If Rain water harvesting please indicate the approach used
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Any other relevant information
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☐ Other
Please specify
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Please provide plans and calculations to support the information provided above

4.5Surface Water Design (please tick appropriate boxes)

WhatSUDS(SustainableUrbanDrainageSystem)measuresare beingusedtomanage
Surface Water,if any
☐ Detentionpond
☐ Detentionbasin
☐ Undergroundstorage
☐ Infiltrationtrench
☐ Other
Please specify
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4.6 TradeEffluent

Thepurposeofthissectionistohighlightintenttodischarge.FormalTradeEffluentConsent applicationsshouldbemade bysubmittingFormG/02 tothe relevantWholesaler.
Is there expectedtobeTradeEffluentdischargeatthe development?
☐ Yes
☐ No
If yes,please provide thefollowingbelow(if known).
Descriptionof thenature of the proposeddischarge
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......
Proposed maximum daily discharge volume (m3/day)......
Proposed maximum discharge rate (litres/second)......
Proposed period/s of discharge (normal working hours during day)......
ProposedTradeEffluenttreatmentgivenatsite (e.g.oilseparation,balancing,pHcorrection, chemicalorbiologicaltreatment)
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  1. Specialrequirements

Pleaseoutlinespecialrequirementsasappropriate
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5.1 Requestforthe Wholesaler(s)toassisttheNon-HouseholdCustomer withthe technicalaspectsofwhatisneededtocompletethe developmentimpactassessment

Whereanapplicationformandthe necessarytechnicalinformationisdeemedtobematerially incompleteby the Wholesaler,the developmentimpactassessmentwillnotproceeduntilthe necessarytechnicalinformationisprovidedby theRetailer.Alternatively,theRetailermay requestthatthe WholesalerassiststheNon-HouseholdCustomerwiththetechnicalaspectsof whatisneededtocompletetheapplicationsuchthattheWholesalermaycompletethe developmentimpactassessment,byindicatingbelow
☐I hereby request that the Wholesaler assists the Non-Household Customer to complete the technical details required for the development impact assessment
Pleaseprovide the primaryNon-HouseholdCustomercontactdetailstoassistwiththetechnical aspectsofwhatisneededtocompletethe developmentimpactassessment
Company name......
Contact name......
Contact number......
Contact email......
  1. *Declaration

I /Weunderstandthatanyalterationmade tothisapplicationmustbedeclaredtotheWholesaler
I /Wehave filledinallthe relevantsectionsofthisform.ThedetailsI/we have givenwiththis applicationareaccurate
I /Wehave readandunderstoodthesupportingguidancenotes
I /Wehave enclosedallthe necessarysupportingdocumentationtickappropriateboxes below)
Iherebyacknowledgeanddeclare thattheinformationprovidedinthisformiscorrecttothebest ofmyknowledgeanduptodateatthe dateofsubmission
☐ Undergroundstorage
☐ Infiltrationtrench
☐ Other
Please specify
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Your details
Signature......
Date(dd/mm/yy)......
Fullname (incapitals)......
Role inthecompanyorjobtitle......

Form A/01Pre-application enquiry in relation to a new connection or connections

Version 20160301Page 1 of 10