Residential Orders for Builders Request Form

* Required Fields

*Type of Order:
New ServiceMeter Only

*Date Needed:

*Job Site Contact:

*Job Site Phone Number:

*Builder Name:

*Lot:

*SubDivision and Section:

*Service Address:

*Zip Code:

*Square Footage:

Appliance Information (please check all that apply and list # of units if greater than one):

Furnace
Water Heater
Fireplace (logs)
Fireplace (lighter)
Range
Dryer
Grill
Outdoor Light
Garage Heater
Add on Heat Pump

Please list additional appliances:

*Meter Location:
MarkedStakedStubbed Out

*Type of Pipe used in Home:
Black SteelCSST

*Pressure:
6"2 LB