New Construction Gas Service Application

1 New Construction Gas Service ApplicationNew or Future Home or BuildingConversion of Existing Home or BuildingStandby Service Line Tap (for gas well consumers)Add Equipment - Increase LoadRemove Equipment - Decrease LoadSubdivide Property - Split LoadRelocate Existing Service Line Tap (fees may apply)ResidentialSingle Family HomeCondo/TownhouseCommercialApartmentsM obile HomeYesNoIndustrialRetail/OfficeGarageLo t Plan DevelopmentManufacturingOtherIf Yes, Business Partner ID#Natural Gas EquipmentFurnace(s)Water Heater(s)QtyExistingExisting*To accurately size meter(s), the BTU/h rating of all existing and proposed equipment must be listed.

2 If more than one meter is requested, complete Page Breakdown - Load Required* Service RequestNote: This form is meant for properties that have (1) never before had gas Service installed (2) had gas Service installed at one time but require reconnection, or (3) existing gas Service but wish to change the current load or meter requirements. Please ensure all required information is available before submitting your form. Partial or blank forms will not be reviewed. Once a request is processed an email confirmation will be sent. Before you dig, call 811. To learn more about the 811 process, visit LocationAddressOther:Other:Other:Rooftop Unit(s)# of Residential UnitsContact NameBilling Account**Include information of person or organization responsible for payment of statements once meter(s) are or OrganizationExisting Peoples Customer?

3 Property Details*# of Additional MetersTotal Meters# of Existing Meters*An equipment breakdown is needed for each Details*Existing Meters on-site?Mailing AddressContact NameCity, State, ZipPhone #Type of PhoneE-mailYesNoE-mailCity, State, ZipMailing AddressRange(s)Cooktop(s)Clothes Dryer(s)Fireplace(s)Gas LogsBoiler(s)Grill(s)Generator(s)Pool Heater(s)As NeededExistingWithin 3 yearsAs NeededBTU/hInstallation StatusExistingWithin 3 yearsAs NeededPlease complete & e-mail to:# of Commercial UnitsExistingWithin 3 yearsAs NeededWithin 3 yearsAs NeededExistingWithin 3 yearsAs NeededExistingWithin 3 yearsAs NeededExistingWithin 3 yearsAs NeededWithin 3 yearsAs NeededExistingWithin 3 yearsAs NeededExistingWithin 3 yearsAs NeededPremise UsePremise TypeService Address:Unit fax to: 412-258-2190 ExistingWithin 3 yearsAs NeededExistingWithin 3 yearsAs NeededExistingWithin 3 yearsAs NeededExistingWithin 3 yearsAs NeededExistingWithin 3 yearsPeoples standard delivery pressure at the meter is 7" (4oz.)

4 **Applicant should assume a delivery pressure of 7" (4oz.) for typical design purposes. Higher delivery pressure may be available for Commercial and Industrial customers dependent on main line pressure in the immediate vicinity of the Service location. A Commercial or Industrial applicant requesting delivery pressure greater than 7" (4oz.) must submit a cut sheet showing required range for each piece of gas equipment. Approval of such request shall be at Peoples' reasonable discretion. *Specify amount requested in PSI, or ounces:Project requires higher delivery " (4oz.) at the meter(s) is Existing ServiceInstall New ServiceCurrent Energy Source (if converting)City, State, ZipCounty, MunicipalityHow would you like to receive correspondence?

5 Date Service Needed byContact for RequestTax Parcel IDE-mailUSPS MailPage 1**= required field**412-258-2910 New Construction Gas Service ApplicationAdditional Meter(s) Equipment BreakdownService Address:Unit #Complete an equipment breakdown chart for each existing or proposed unit intended for installation atthe property. Create copy of Page 2 if more than 4 meters Gas EquipmentQtyBTU/hInstallation StatusCurrent Energy Source (if converting)ExistingWithin 3 yearsAs NeededFurnace(s)ExistingWithin 3 yearsAs NeededWater Heater(s)ExistingWithin 3 yearsAs NeededRange(s)ExistingWithin 3 yearsAs NeededCooktop(s)ExistingWithin 3 yearsAs NeededClothes Dryer(s)ExistingWithin 3 yearsAs NeededFireplace(s)ExistingWithin 3 yearsAs NeededGas LogsExistingWithin 3 yearsAs NeededBoiler(s)ExistingWithin 3 yearsAs NeededGrill(s)ExistingWithin 3 yearsAs NeededGenerator(s)ExistingWithin 3 yearsAs NeededPool Heater(s)

6 ExistingWithin 3 yearsAs NeededRooftop Unit(s)ExistingWithin 3 yearsAs NeededOther:ExistingWithin 3 yearsAs NeededOther:ExistingWithin 3 yearsAs NeededOther: Service Address:Unit #Natural Gas EquipmentQtyBTU/hInstallation StatusCurrent Energy Source (if converting)ExistingWithin 3 yearsAs NeededFurnace(s)ExistingWithin 3 yearsAs NeededWater Heater(s)ExistingWithin 3 yearsAs NeededRange(s)ExistingWithin 3 yearsAs NeededCooktop(s)ExistingWithin 3 yearsAs NeededClothes Dryer(s)ExistingWithin 3 yearsAs NeededFireplace(s)ExistingWithin 3 yearsAs NeededGas LogsExistingWithin 3 yearsAs NeededBoiler(s)ExistingWithin 3 yearsAs NeededGrill(s)ExistingWithin 3 yearsAs NeededGenerator(s)ExistingWithin 3 yearsAs NeededPool Heater(s)ExistingWithin 3 yearsAs NeededRooftop Unit(s)

7 ExistingWithin 3 yearsAs NeededOther:ExistingWithin 3 yearsAs NeededOther:ExistingWithin 3 yearsAs NeededOther: Service Address:Unit #Natural Gas EquipmentQtyBTU/hInstallation StatusCurrent Energy Source (if converting)ExistingWithin 3 yearsAs NeededFurnace(s)ExistingWithin 3 yearsAs NeededWater Heater(s)ExistingWithin 3 yearsAs NeededRange(s)ExistingWithin 3 yearsAs NeededCooktop(s)ExistingWithin 3 yearsAs NeededClothes Dryer(s)ExistingWithin 3 yearsAs NeededFireplace(s)ExistingWithin 3 yearsAs NeededGas LogsExistingWithin 3 yearsAs NeededBoiler(s)ExistingWithin 3 yearsAs NeededGrill(s)ExistingWithin 3 yearsAs NeededGenerator(s)ExistingWithin 3 yearsAs NeededPool Heater(s)ExistingWithin 3 yearsAs NeededRooftop Unit(s)

8 ExistingWithin 3 yearsAs NeededOther:ExistingWithin 3 yearsAs NeededOther:ExistingWithin 3 yearsAs NeededOther:Page 2 Commercial, Industrial or Lot Development Projects ONLYNew Construction Gas Service ApplicationThe following should be completed for all Commercial, Industrial or Lot Development projects. Please include contact information for the person responsible for sizingthe customer Service and house lines. Additionally, a site utility plan showing all existing and proposed Service line routing and meter location(s) must be Project Start DateCurrent Status of ProjectPlanningFoundation PouredFraming CompleteAre multiple phases planned forthis project?

9 Insulation CompleteYesN/AInspection CompleteNoClosingProject correspondence will be sent to the preferred contact noted on Page1 as well as any contact noted on Page 3. Peoples assumes noresponsibility for issues resulting from miscommunication betweenApplicant is the responsibility of the Applicant to provide accurate information in this Application and to update Peoples of any changes to loads, pressures, equipment, billing,and/or contacts from what is stated in this Application . If any Service changes are necessary due to inaccurate or updated information, the Application will bereevaluated. If Peoples is still able to provide gas Service , Applicant contribution in aid of Construction may change (if applicable).

10 In addition, Applicant will beresponsible for payment to Peoples for any incremental costs incurred by Peoples as a result of the change(s), which may include but not be limited to equipmentcosts, meter fabrication costs, and engineering you have questions regarding installation specifications, please speak with your qualifiedinstaller or reference Peoples' Standards of Installation document, available online here: you have questions regarding process or status of your Application , please contact usby email at or phone at (866) 654-4660,Monday-Friday 8:00am-4:00pm, 3 Additional Project DetailsProject TitleBuilder/Developer NamePreferred Project ContactContact NameContact PhoneHow would you like to receive correspondence?