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Commercial Online Application
Commercial Online Application
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2020-08-19T10:19:37-08:00
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Commercial Application
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General Information
Company/Owner
*
Mailing Address
*
Mailing Address
Street Address
Street Address
Address line 2
Address line 2
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
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South Carolina
South Dakota
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Texas
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Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Contact Person
*
Business Phone
*
Cell Phone
Email Address
*
Enter Email
Confirm Email Address
*
Confirm Email
Billing Contact
*
Billing Phone
*
Lot/Block
Service Address (number/mile and street name/highway)
Service Address (number/mile and street name/highway)
Service Address (number/mile and street name/highway)
Service Address (number/mile and street name/highway)
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Nearest Cross Street
Parcel ID #
*
Leased/Owned
*
Building Description - Select all that apply
*
Small Commercial
Large Commercial
4-Plex
Firm Service
Interruptible Service
Other
Other
Total Square Footage of Building:
*
Total Square Footage of Unit served by meter:
*
Lot Readiness - Select all that apply
*
Lot Cleared
Framed
Ready for Gas Now
Foundation Backfilled?
*
Yes
No
Expected Date
*
Delivery Pressure Required
*
7" WC (Standard)
2 psig
Check any underground obstructions that apply and indicate on drawing:
*
Underground wiring
Oil lines & tank
Well
Septic/Water/Sewer
*No obstructions per Customer
Other (sprinklers, phone, Internet, fiber optic, cable)
Other (sprinklers, phone, Internet, fiber optic, cable)
Initial
*
Clear
If you are human, leave this field blank.
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