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Fields marked with * are required

Customer Name *

Contact Name *

Contact Telephone *

Email Address *

Site Name *

Site Address *

Town *

Postcode *

Has planning permission been granted for the development? *

If YES - please provide the planning reference number

Yes

Number of plots requiring Gas connection *

Would you like a budget estimate or firm quotation? *

Property type requiring connection eg: 2BS,3BT,4BD *

Is the Property Grade Listed? *

Yes

Will the works require crossing shared or private land that you do not own? *

Yes

Date Service Are Required on by

Gas

Plan Location

Site Layout Plan – showing the building and the surrounding area *

Please Note. We can't move your application to the next stage until these documents have been uploaded.

Drag and Drop here

Allowed file types: PDF, DOC, DOCX, JPG, JPEG, PNG, GIF, BMP, TIFF, TIF

Location Plan – showing the development in relation to nearby roads *

Please Note. We can't move your application to the next stage until the Location Plan has been uploaded.

Drag and Drop here

Allowed file types: PDF, DOC, DOCX, JPG, JPEG, PNG, GIF, BMP, TIFF, TIF

Gas Use

Will the property have gas central heating? *

Yes

Will the property be using more than 60kw? *

If YES - please provide the plot numbers of all properties using more than 60KW

Yes

Excavation

Will you be completing the excavation within the site boundary? *

Yes

Thank you!

Your request has been received.

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