Scope of Works

• S/O & Address

• RSP

• RFS Date

• Conducted by - (Enter name here)

• Conducted On

  Date

CUSTOMER DETAILS:

• Name & Contact Number:

• Customer Notes:

SITE INFO

• Dog on site?

  YES

  NO

• Locked Premises?

  YES

  NO

• Premises type

  Residential SDU

  Right Of Way

  Multi Dwelling Unit

  Business

• Site Notes:

CIVIL WORK DETAIL

• Boundary surface type

  Select Grass Asphalt Concrete Chipseal Dirt

  • Grass
  • Asphalt
  • Concrete
  • Chipseal
  • Dirt

• What type of civil work is to be completed?

  Select Undermine Surface Mount Grass Trench Terrasaw Trench Asphalt slot trench Asphalt Trench Paving / Tiles Hard Surface Trench Concrete trench Concrete Slot trench Thrust Conduit PALI - (No Civil required) PALI - (Civil to extend pali) Greenfields NO CIVIL/BLOW REQUIRED - CONNECT INSTALL ONLY Other - Please Specify

  • Undermine
  • Surface Mount
  • Grass Trench
  • Terrasaw Trench
  • Asphalt slot trench
  • Asphalt Trench
  • Paving / Tiles
  • Hard Surface Trench
  • Concrete trench
  • Concrete Slot trench
  • Thrust
  • Conduit
  • PALI - (No Civil required)
  • PALI - (Civil to extend pali)
  • Greenfields
  • NO CIVIL/BLOW REQUIRED - CONNECT INSTALL ONLY
  • Other - Please Specify

• Distance of each work type:

• Total Distance

CONSENT

• "I" the property occupant am aware with the scheduled maintenence of the "chorus telecommunication network" and agree to contractors proposed civil method/s and route in order to complete scheduled maintenence work to service my property

• Authorized property occupant

  Sign

• Chorus representative

  Sign

PHOTOS

• Outline of Civil works

  Media