CommentsThis field is for validation purposes and should be left unchanged.Applicant InformationThe Application Requirements must be met before your application can be accepted.Developer InformationBusiness Name(Required)Contact Name(Required)Federal Tax ID Number(Required)Office Phone(Required)Cell Phone(Required)Email(Required) Mailing Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Site InformationSubdivision Name(Required)Total Number of Lots(Required)Tax Lot Number(Required)Nearest Cross Street(Required)Owner Information (if different from above)Name First Last Office PhoneCell PhoneEmail Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code General Contractor/Onsite ContractContact Name(Required)Company(Required)Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone(Required)ElectricService(Required) Single Family Duplex Common Wall (sep tax lots) Duplex Standard (1 tax lot) Townhouse/Condominium (1 tax lot) Tracts Number of Single Family ServicesNumber of Duplex Common Wall ServicesNumber of Duplex Standard ServicesNumber of Townhouse/Condominium ServicesNumber of Tracts ServicesWill Subdivision be served by Natural Gas?(Required) Yes No WaterTotal Number of Domestic Water Services(Required)Total Number of Irrigation Water Services(Required)Domestic Water Meter Size(Required) 3/4 inches 1 inch Other Irrigation Water Meter(Required)Note: Backflow protection is required on all irrigation services prior to turning water meter on 3/4 inches 1 inch Other Well on property(Required) Yes No Additional RemarksConsent(Required)Applicant may not authorize a bill to a second party.Note: Any deviation from the approved water/electrical design may result in additional costs for redesign and construction may be delayed. It is the customer’s responsibility to provide all the necessary MW&L requirements and specifications to the subcontractor.I affirm that the above information is correct to the best of my knowledge. I have read and agree to the Subdivision Design Application Requirements. I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Applicant Electronic Signature (Full Name)(Required)Date (mm/dd/yyyy)(Required) Month Day Year CAPTCHA