Notification of the demolition of your building in the case of underground infrastructure or request for a (temporary) move of our above-ground infrastructure (on facade)

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Title {{errorMessages.title.required}} {{errorMessages.title.pattern}}

First name {{errorMessages.firstname.required}} {{errorMessages.firstname.pattern}} {{errorMessages.firstname}}

Name {{errorMessages.name.required}} {{errorMessages.name.pattern}} {{errorMessages.name}}

Installation address

Street {{errorMessages.street.required}} {{errorMessages.street.pattern}} {{errorMessages.street}}

Number {{errorMessages.number.required}} {{errorMessages.number.pattern}} {{errorMessages.number}}

Box (optional) {{errorMessages.box.required}} {{errorMessages.box.pattern}} {{errorMessages.box}}

Zip code {{errorMessages.zip.required}} {{errorMessages.zip.pattern}} {{errorMessages.zip}}

City {{errorMessages.city.required}} {{errorMessages.city.pattern}} {{errorMessages.city}}

Contact number {{errorMessages.contactnumber.required}} {{errorMessages.contactnumber.pattern}}

Mobile number {{errorMessages.mobile.required}} {{errorMessages.mobile.pattern}} {{errorMessages.mobile}}

Fix number {{errorMessages.fixnumber.required}} {{errorMessages.fixnumber.pattern}} {{errorMessages.fixnumber}}

Email address (for receiving a copy of this order) {{errorMessages.email.required}} {{errorMessages.email.pattern}} {{errorMessages.email}}

Demolition date {{errorMessages.installdate.required}} {{errorMessages.installdate.pattern}} {{errorMessages.installdate}}

Comments (optional) {{errorMessages.comments.required}} {{errorMessages.comments.pattern}} {{errorMessages.comments}}

Demolition type Demolition underground infrastructure Demolition surface infrastructure Move first connexionpoint

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Notification of the demolition of your building in the case of underground infrastructure or request for a (temporary) move of our above-ground infrastructure (on facade)

Personal data

Installation address

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Notification of the demolition of your building in the case of underground infrastructure or request for a (temporary) move of our above-ground infrastructure (on facade)

Personal data

Installation address

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