Fibre Installation Consent Form

I hereby acknowledge that Axle Telecom, or the contractors acting on behalf of Axle, will be burying fibre optic cable from the road allowance to a demarcation point on my dwelling. Any disturbance to the landscape will be repaired by the contractor.

I acknowledge that Axle will be installing a Network Interface Device (NID) in my premises to connect the fibre optic cable to my inside wire.

Property Information

Fields marked with an asterisk are mandatory

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Thank you for submitting your Consent Form, we have confirmed receipt.

Address Line 1*

Address Line 2

City*

Province*

Postal Code*

Full Name*

Phone Number*

Alternate Contact Number

Email*

Own or Rent*

If renting, provide property owner’s name

Property owner’s phone number

Property owner’s email address

Other Services on Property

Do you have anything in the ground that would not be captured with utility locates?*
Eg. underground sprinkler system, septic system, electronic fencing.

If yes, please elaborate on what it is and where specifically on the property it is located.

Please let us know the approximate location of the hydro metre and the electrical panel in your home.
Which side of the house will work.*

Is there anything in the ground within 5 feet of either side of your driveway? If yes, please provide details.

Please contact me with information about Axle Telecom fibre services when they become available in my area.