{"id":37484,"date":"2022-02-16T10:27:01","date_gmt":"2022-02-16T15:27:01","guid":{"rendered":"https:\/\/ure.com\/?page_id=37484"},"modified":"2022-06-29T11:11:27","modified_gmt":"2022-06-29T15:11:27","slug":"new-residential-service","status":"publish","type":"page","link":"https:\/\/ure.com\/services\/natural-gas\/residential-service\/new-residential-service\/","title":{"rendered":"New Home Construction &#8211; Natural Gas"},"content":{"rendered":"<h2>New Home Construction Questionnaire<\/h2>\n<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_safari gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_40' ><div id='gf_40' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_40'  action='\/wp-json\/wp\/v2\/pages\/37484#gf_40' data-formid='40' novalidate>\n        <div id='gf_progressbar_wrapper_40' class='gf_progressbar_wrapper'>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>3<\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_custom' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_custom percentbar_0' style='width:0%; color:#211f1d; background-color:#f5d896;'><span>0%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_40_1' class='gform_page ' data-js='page-field-id-1' >\n                                    <div class='gform_page_fields'><div id='gform_fields_40' class='gform_fields top_label form_sublabel_above description_above'><fieldset id=\"field_40_54\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_54\"><legend class='gfield_label gform-field-label'  >** NOTE TO APPLICANT: If your deed information is not available at this time, you may submit your application to begin the new service process. HOWEVER, this information MUST be submitted to URE and an easement created and signed by the homeowners BEFORE any URE facilities will be installed.**<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_40_54'>\n\t\t\t<div class='gchoice gchoice_40_54_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='I AGREE to provide all necessary documents'  id='choice_40_54_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_40_54_0' id='label_40_54_0' class='gform-field-label gform-field-label--type-inline'>I AGREE to provide all necessary documents<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_40_4\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_4\"><legend class='gfield_label gform-field-label'  >Choose One Option<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_40_4'>\n\t\t\t<div class='gchoice gchoice_40_4_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='I am the homeowner'  id='choice_40_4_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_40_4_0' id='label_40_4_0' class='gform-field-label gform-field-label--type-inline'>I am the homeowner<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_40_4_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='I am the builder\/contractor'  id='choice_40_4_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_40_4_1' id='label_40_4_1' class='gform-field-label gform-field-label--type-inline'>I am the builder\/contractor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_40_4_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='gf_other_choice'  id='choice_40_4_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_40_4_2' id='label_40_4_2' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_40_4_other' class='gchoice_other_control' name='input_4_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_40_1\"  class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_1\"><h3 class=\"gsection_title\">Contact Information<\/h3><\/div><fieldset id=\"field_40_3\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_3\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_40_3'>\n                            \n                            <span id='input_40_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_40_3_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_3.3' id='input_40_3_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_40_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_40_3_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_3.6' id='input_40_3_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_40_5\"  class=\"gfield gfield--type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_5\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >Service Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_40_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_40_5_1_container' >\n                                        <label for='input_40_5_1' id='input_40_5_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_5.1' id='input_40_5_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_40_5_3_container' >\n                                    <label for='input_40_5_3' id='input_40_5_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_5.3' id='input_40_5_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_40_5_4_container' >\n                                        <label for='input_40_5_4' id='input_40_5_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_5.4' id='input_40_5_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' selected='selected'>Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_40_5_5_container' >\n                                    <label for='input_40_5_5' id='input_40_5_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_5.5' id='input_40_5_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_5.6' id='input_40_5_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_40_6\"  class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_6\"><label class='gfield_label gform-field-label' for='input_40_6' >Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_40_6' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_40_7\"  class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_7\"><label class='gfield_label gform-field-label' for='input_40_7' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_7' id='input_40_7' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_40_8\"  class=\"gfield gfield--type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_8\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >Mailing Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    <div id='input_40_8_copy_values_option_container' class='copy_values_option_container' >\n                                        <input type='checkbox' id='input_40_8_copy_values_activated' class='copy_values_activated' value='1' data-source_field_id='5' name='input_8_copy_values_activated'  \/>\n                                        <label for='input_40_8_copy_values_activated' id='input_40_8_copy_values_option_label' class='copy_values_option_label inline gform-field-label gform-field-label--type-inline'>Same as Service Address<\/label>\n                                    <\/div>\n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_40_8' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_40_8_1_container' >\n                                        <label for='input_40_8_1' id='input_40_8_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_8.1' id='input_40_8_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_40_8_3_container' >\n                                    <label for='input_40_8_3' id='input_40_8_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_8.3' id='input_40_8_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_40_8_4_container' >\n                                        <label for='input_40_8_4' id='input_40_8_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_8.4' id='input_40_8_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' selected='selected'>Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_40_8_5_container' >\n                                    <label for='input_40_8_5' id='input_40_8_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_8.5' id='input_40_8_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_8.6' id='input_40_8_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_40_9\"  class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_9\"><h3 class=\"gsection_title\">Builder\/Contractor Information<\/h3><\/div><div id=\"field_40_44\"  class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_44\"><label class='gfield_label gform-field-label' for='input_40_44' >Name of Builder\/Contractor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_44' id='input_40_44' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_40_12\"  class=\"gfield gfield--type-phone gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_12\"><label class='gfield_label gform-field-label' for='input_40_12' >Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_12' id='input_40_12' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_40_13\"  class=\"gfield gfield--type-email gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_13\"><label class='gfield_label gform-field-label' for='input_40_13' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_13' id='input_40_13' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_40_11\"  class=\"gfield gfield--type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_11\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >Mailing Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_40_11' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_40_11_1_container' >\n                                        <label for='input_40_11_1' id='input_40_11_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_11.1' id='input_40_11_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_40_11_3_container' >\n                                    <label for='input_40_11_3' id='input_40_11_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_11.3' id='input_40_11_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_40_11_4_container' >\n                                        <label for='input_40_11_4' id='input_40_11_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_11.4' id='input_40_11_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' selected='selected'>Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_40_11_5_container' >\n                                    <label for='input_40_11_5' id='input_40_11_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_11.5' id='input_40_11_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_11.6' id='input_40_11_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_40_40' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_40\").val(\"2\");  jQuery(\"#gform_40\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_40\").val(\"2\");  jQuery(\"#gform_40\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_40_2' class='gform_page' data-js='page-field-id-40' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_40_2' class='gform_fields top_label form_sublabel_above description_above'><div id=\"field_40_14\"  class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_14\"><h3 class=\"gsection_title\">Natural Gas Load Information<\/h3><\/div><div id=\"field_40_16\"  class=\"gfield gfield--type-number gfield--width-half field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_16\"><label class='gfield_label gform-field-label' for='input_40_16' >Furnace British Thermal Units (BTU) per Hour<\/label><div class='ginput_container ginput_container_number'><input name='input_16' id='input_40_16' type='number' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_40_21\"  class=\"gfield gfield--type-number gfield--width-half field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_21\"><label class='gfield_label gform-field-label' for='input_40_21' >Water Heater BTU per Hour<\/label><div class='ginput_container ginput_container_number'><input name='input_21' id='input_40_21' type='number' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_40_20\"  class=\"gfield gfield--type-number gfield--width-half field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_20\"><label class='gfield_label gform-field-label' for='input_40_20' >Dryer BTU per Hour<\/label><div class='ginput_container ginput_container_number'><input name='input_20' id='input_40_20' type='number' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_40_19\"  class=\"gfield gfield--type-number gfield--width-half field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_19\"><label class='gfield_label gform-field-label' for='input_40_19' >Gas Logs BTU per Hour<\/label><div class='ginput_container ginput_container_number'><input name='input_19' id='input_40_19' type='number' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_40_18\"  class=\"gfield gfield--type-number gfield--width-half field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_18\"><label class='gfield_label gform-field-label' for='input_40_18' >Cook Stove BTU per Hour<\/label><div class='ginput_container ginput_container_number'><input name='input_18' id='input_40_18' type='number' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_40_17\"  class=\"gfield gfield--type-number gfield--width-half field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_17\"><label class='gfield_label gform-field-label' for='input_40_17' >Other Natural Gas Appliances BTU per Hour<\/label><div class='ginput_container ginput_container_number'><input name='input_17' id='input_40_17' type='number' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_40_51\"  class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_51\"><label class='gfield_label gform-field-label' for='input_40_51' >Total Load BTU per Hour or Standard Cubic Feet per Hour (SCFH)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_40_51' type='text' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_40_50\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_50\"><legend class='gfield_label gform-field-label'  >Required Delivery Pressure<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_40_50'>\n\t\t\t<div class='gchoice gchoice_40_50_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Standard (7&quot; wc)'  id='choice_40_50_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_40_50_0' id='label_40_50_0' class='gform-field-label gform-field-label--type-inline'>Standard (7\" wc)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_40_50_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='2 PSI'  id='choice_40_50_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_40_50_1' id='label_40_50_1' class='gform-field-label gform-field-label--type-inline'>2 PSI<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_40_50_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='gf_other_choice'  id='choice_40_50_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_40_50_2' id='label_40_50_2' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_40_50_other' class='gchoice_other_control' name='input_50_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_40_42' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_40\").val(\"1\");  jQuery(\"#gform_40\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_40\").val(\"1\");  jQuery(\"#gform_40\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_40_42' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_40\").val(\"3\");  jQuery(\"#gform_40\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_40\").val(\"3\");  jQuery(\"#gform_40\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_40_3' class='gform_page' data-js='page-field-id-42' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_40_3' class='gform_fields top_label form_sublabel_above description_above'><div id=\"field_40_23\"  class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_23\"><h3 class=\"gsection_title\">Easement<\/h3><\/div><div id=\"field_40_24\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_24\"><p>If an easement is required, much of the information will be on the grantor's deed\/general warranty deed.<\/p>\n<p>Your county agency (auditor's office or recorder's office) will be able to help you obtain these requirements.<\/p>\n<p>Attach the grantor's deed\/general warranty deed - must include the following:<\/p><\/div><div id=\"field_40_25\"  class=\"gfield gfield--type-text field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_25\"><label class='gfield_label gform-field-label' for='input_40_25' >Official Name on Deed<\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_40_25' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_40_26\"  class=\"gfield gfield--type-text field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_26\"><label class='gfield_label gform-field-label' for='input_40_26' >The Recorded Instrument Number from the Grantor&#039;s Deed\/General Warranty Deed<\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_40_26' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_40_27\"  class=\"gfield gfield--type-text gfield--width-half field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_27\"><label class='gfield_label gform-field-label' for='input_40_27' >The Parcel Number Where the Easement Will Reside (Not the Parent Parcel)<\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_40_27' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_40_28\"  class=\"gfield gfield--type-text gfield--width-half field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_28\"><label class='gfield_label gform-field-label' for='input_40_28' >Number of Acres of the Parcel (Not the Parent Parcel)<\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_40_28' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_40_29\"  class=\"gfield gfield--type-fileupload field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_29\"><label class='gfield_label gform-field-label' for='input_40_29' >Attach Grantor&#039;s Deed\/General Warranty Deed<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='536870912' \/><input name='input_29' id='input_40_29' type='file' class='large' aria-describedby=\"gfield_upload_rules_40_29\" onchange='javascript:gformValidateFileSize( this, 536870912 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_40_29'>Max. file size: 512 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_40_29'><\/div><\/div><\/div><div id=\"field_40_30\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_30\"><p>Attach the written legal description of the parcel \u2013 must include the following (not the parent parcel):<\/p><\/div><div id=\"field_40_32\"  class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_32\"><label class='gfield_label gform-field-label' for='input_40_32' >County the Parcel Resides In<\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_40_32' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_40_31\"  class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_31\"><label class='gfield_label gform-field-label' for='input_40_31' >Virginia Military Survey # (VMS)<\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_40_31' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_40_33\"  class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_33\"><label class='gfield_label gform-field-label' for='input_40_33' >Township the Parcel Resides In<\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_40_33' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_40_35\"  class=\"gfield gfield--type-fileupload gfield--width-full field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_35\"><label class='gfield_label gform-field-label' for='input_40_35' >Attach Written Legal Description of the Parcel<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='536870912' \/><input name='input_35' id='input_40_35' type='file' class='large' aria-describedby=\"gfield_upload_rules_40_35\" onchange='javascript:gformValidateFileSize( this, 536870912 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_40_35'>Max. file size: 512 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_40_35'><\/div><\/div><\/div><div id=\"field_40_34\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_34\"><p>Before a site meeting can be scheduled, the following must be completed<\/p>\n<ul>\n<li>Complete a new member application (if not already a member of URE)<\/li>\n<li>New construction location must be professionally staked<\/li>\n<li>Property pins must be. located<\/li>\n<li>Site plan was filed with the county\/township (this shows septic, well, driveway, house, etc<\/li>\n<li>Septic must be staked (for non-subdivision home)<\/li>\n<li>Well location must be known (for non-subdivision home)<\/li>\n<li>Driveway must be staked<\/li>\n<li>Property must be accessible \u2013 URE employee must be able to take measurements and locate stakes (area and terrain cleared)<\/li>\n<\/ul>\n<h2>Site Meeting For New Construction<\/h2><\/div><div id=\"field_40_36\"  class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_36\"><label class='gfield_label gform-field-label' for='input_40_36' >Who Will Be At the Site Meeting?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_40_36' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_40_38\"  class=\"gfield gfield--type-phone gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_38\"><label class='gfield_label gform-field-label' for='input_40_38' >Best Contact Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_40_38'>(in the event the meeting needs to be rescheduled)<\/div><div class='ginput_container ginput_container_phone'><input name='input_38' id='input_40_38' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_40_38\"  \/><\/div><\/div><fieldset id=\"field_40_39\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_39\"><legend class='gfield_label gform-field-label'  >New Home Specifications<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_40_39'>\n\t\t\t<div class='gchoice gchoice_40_39_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Single family'  id='choice_40_39_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_40_39_0' id='label_40_39_0' class='gform-field-label gform-field-label--type-inline'>Single family<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_40_39_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Multi-family'  id='choice_40_39_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_40_39_1' id='label_40_39_1' class='gform-field-label gform-field-label--type-inline'>Multi-family<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_40_39_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Duplex'  id='choice_40_39_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_40_39_2' id='label_40_39_2' class='gform-field-label gform-field-label--type-inline'>Duplex<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_40_39_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Mobile home'  id='choice_40_39_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_40_39_3' id='label_40_39_3' class='gform-field-label gform-field-label--type-inline'>Mobile home<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_40_43\"  class=\"gfield gfield--type-text field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_43\"><label class='gfield_label gform-field-label' for='input_40_43' >Additional Information you&#039;d like to provide<\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_40_43' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_40_55\"  class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_40_55\"><label class='gfield_label 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