APPLICATION FOR RESIDENTIAL NATURAL GAS SERVICE
ON EXISTING MAIN
Questions? Please call us at 1(888) GAS-MAIN or 1(888) 427-6246
Monday through Friday 8:00 am to 4:30 pm (Closed Saturdays, Sundays and holidays).
INSTRUCTIONS: Please fill out this form (pages 1 and 2), sign and return below by MM/DD/YY. Your return options are:
E-Mail to: cap_support_ctr@cmsenergy.com. Please type: “
” in the subject line
or Mail to: Consumers Energy Gas Support Center, 2400 Weiss St, Rm 113, Saginaw, MI 48602-3890
*** NO PAYMENT IS REQUIRED AT THIS TIME ***
PLEASE NOTE
Setting up your new gas account as required by the Fair and Accurate Credit Transactions Act (FACTA):
After you receive a letter from Consumers Energy notifying you that your project has met the 50% required participation, please contact us at
1(888) 427-6246, Option 2, to create your new gas account. To help protect you from identity theft, our representative will ask you for your
Social Security Number, Birth Date and Driver’s License Number in order to set up the new gas account. If you choose not to provide us with
this information, we cannot validate your identity over the phone and you will need to validate your identity in person before we can offer you
gas service. To validate your identity in person, please call us at 1(888) 427-6246, Option 4, to locate our nearest DPO office. We do not
access your credit report.
First Name
Middle Initial
Last Name
Legal Name of Property Owner
Contact Information
Home Phone (with Area Code)
Cell Phone (with Area Code)
(
(
)
Street (Include apartment/suite #)
Service Address (where the gas
service will be installed)
)
City
County
State
Zip Code
State
Zip Code
Township
Street (Include apartment/suite #, OR
PO Box, if applicable)
Mailing Address (if different from
address above)
E-Mail Address
City
PROPERTY DESCRIPTION - CHECK APPROPRIATE BOX(ES):
FOR WHICH APPLIANCE WILL YOU BE USING NATURAL GAS:
Single Family Dwelling
Multi-Family Dwelling (i.e. Duplex)
Mobile Home
Non-Dwelling (i.e. Pole Barn, Garage)
Appliance
Quantity
Load (in BTU’s)*
Furnace / Boiler
Other
Standard Water Heater
CUSTOMER ATTACHMENT PROGRAM (CAP) CHARGES
Tankless Water Heater
Stove / Range
Connection Fee
$200.00
 You will receive a bill with instructions on how to pay this and any other
applicable charges via check or credit card.
 Excessive service line fee not included in price. Excess service line fee is
subject to payment prior to construction. Please see Terms and
Conditions for pricing details on excess footage charges and all other
charges which are subject to payment prior to construction.
 Our Customer Energy Specialist will inform you of any additional
exceptional cost associated with the installation of your service (e.g.
excessive service line fee, high pressure regulator, directional boring
costs, etc.).
 Please contact us Toll Free at 1(888) 427-6246 to find out if there is an
outstanding main contribution applicable to this service.
BY SIGNING HERE, CUSTOMER ACKNOWLEDGES THE
INFORMATION ATTACHED.
Clothes Dryer
Pool Heater
Fireplace
Generator
Other (specify)
TOTAL Load (in BTU’s)
*To find the BTU size of equipment, refer to the name plate or data plate that is
located on the back/side/inside, typically in sticker form.
TO BE COMPLETED BY CONSUMERS ENERGY
Property Owner Printed Name ___________________________________
CAP Project #/DAPP#
Property Owner Signature (Required) _____________________________
Notification #
Date __________________________
Non-Energy Contract Acct #
Initial here to acknowledge you have read and reviewed the attached Terms and Conditions
Form 1241 11-2015
Page 1 of 3
Service Location Sketch
INSTRUCTIONS: To the best of your ability, please use the drawing box below to identify the location of all private, existing or
proposed, underground installations on your property. Applications without a drawing are considered incomplete and will not
meet application deadline requirements.
IMPORTANT:
1.
Consumers Energy and its contractors will take reasonable care to avoid damage to all underground facilities. However, we cannot
accept responsibility for damages to facilities that are not properly identified on your drawing and exposed or marked with stakes, spray
paint or flags on the jobsite prior to construction.
Consumers Energy will use the MISS DIG system to flag all underground public utilities (e.g. electricity, water, sewer, phone lines, etc.)
Consumers Energy reserves the right to determine the final meter(s) location and/or verify location prior to installation.
After gas service is installed, excavation will be backfilled. Final restoration is the customer’s responsibility.
Consumers Energy reserves the right to delay or deny a request for service, if fulfilling such a request could, in the Company’s opinion,
create conditions potentially adverse to the Company or its customers. Consumers Energy also maintains the right to designate the
location of the meter set assembly, regulator, meter, and other metering facilities. As such, Consumers Energy shall have the right to
determine the final design of any customer attachment project, which includes, but is not limited to, the location of service and all
required meters and the size of service and all required meters.
2.
3.
4.
5.
Building Square Footage
ft
Be sure to include on your drawing:
G = Preferred Gas Meter Location
A = Measurement from closest front corner of building to preferred meter location
B = Total measurement from front property line to preferred meter location
C = Measurement from house to side lot line on meter side of the house
ft
ft
ft
Please draw where the following items are relative to your house in the area below:
For any above or underground facilities or obstacles on your property,
check the appropriate box(es) below and mark them on your drawing:
Yard Lighting
Steep Hill
Retaining Wall
Sewer Lateral
Sprinkler System
Wetlands/Creeks
Electric Dog Fence
Underground Tank/Fuel Lines
Drain Tiles/Downspouts
Customer Underground Wiring
Other - Future decks, additions, structures or fencing
Indicate Nearest Side Street
House
Indicate Nearest Side Street
Well
Septic
Trees
Indicate Service Address
Remember: Customer-owned underground facilities identified in the drawing above must be exposed or marked by the customer prior to
ndi Residence
Street
construction. You will be notified when
we’re getting
ready to install your natural gas service.
E-Mail to: cap_support_ctr@cmsenergy.com. Please type: “
” in the subject line
or Mail to: Consumers Energy Gas Support Center, 2400 Weiss St, Rm 113, Saginaw, MI 48602-3890
Form 1241 11-2015
Page 2 of 3
CUSTOMER COPY
APPLICATION FOR NATURAL GAS SERVICE
GENERAL INFORMATION
CUSTOMER ATTACHMENT PROGRAM (CAP) CHARGES
Connection Fee: The minimum connection fee is $200. Payment is required prior to construction.
Excessive Footage Allowance: Customer Attachment Policy excessive footage allowances and costs effective on March 1, 2015. Payment is required
prior to construction. An excessive service line fee will be charged as follows:
Primary Home- $200 connection fee and $7.76 per foot for all footage over 300 feet.
Larger Volume Meter - If your total connected BTU load, excluding generator and tankless water heater load, necessitates a 425 meter, the connection fee
is $200 and excess footage is $7.76 per foot for all footage over 1076 feet.
High Volume Meter - If your total connected BTU load, excluding generator and tankless water heater load, necessitates a 800 meter, the connection fee
is $200 and excess footage is $7.76 per foot for all footage over 2111 ft.
Mobile Home - $200 connection fee plus $7.76 per foot for all footage over 83 feet.
Seasonal Residence - $200 connection fee plus $7.76 per foot over 0 feet.
Winter Construction and Other Direct Charges: Winter construction charges will be applied to gas facilities installed from December 15 - April 15.
The winter construction charge of $3.00 per foot applies to all footage, measured from the gas main to the meter location. Our Customer Energy Specialist will
inform you of any additional exceptional cost associated with the installation of your service (e.g. high pressure regulator, directional boring costs, etc.).
BEFORE INSTALLATION
 According to public code, your meter cannot be located under or within 18” of an opening first floor window or within two feet of the side of doors which open
or in front of basement windows and must be at least three feet from a power air intake and three feet from any source of ignition.
 Standard meters will be installed two feet above final grade.
 The service line must be at least three feet away from a septic field and cannot run through it.
 Gas service piping should not be located under concrete and must be accessible from property line to meter. However, Consumers Energy is able to bore
under sidewalks and driveways, and gas service may cross under them.
 A 12’ wide service path must be cleared of brush, overgrowth, trees and tree stumps, and other debris for the service installation equipment to avoid
damage to the facilities.
 For safety and accessibility, if the meter is to be located on the driveway-side of the residence, a minimum of three and a half feet is needed between
driveway and building.
 We make arrangements with Miss Dig to have your property staked. However, this does not protect your privately owned facilities (i.e., sprinkler systems
drain tiles, etc.). It is your responsibility to give us an exact location of all private existing or proposed underground installations crossing or paralleling the
route of our proposed construction. ANY UNDERGROUND CUSTOMER-OWNED FACILITIES MUST BE MARKED OR EXPOSED BY THE CUSTOMER.
Consumers Energy and its contractors will take reasonable care to avoid damage to all underground facilities. However, we cannot accept responsibility for
damages to facilities that are not properly identified on your drawing and expose or mark with stakes, spray paint or flags on the jobsite.
 A fully completed application and connection fee for gas service must be received by Consumers Energy by June 1. Applications reviewed after June 1 will
be subject to being deferred until the following year and subject to additional permit fees for installation.
NEW CONSTRUCTION ONLY
 Before service is installed for new buildings, site must be within three inches of final grade, with footings or foundation installed and backfilled. If your home
requires a large meter, the wall must be constructed before the service can be scheduled.
 If you are in the early stages of construction, make sure your basement/foundation is backfilled and the service route from the building to the property line is
within 3” of final grade. If you cannot meet the above conditions before December 1, you may wish to consider installing conduit for your gas service.
Conduits that are property installed and usable will eliminate the winter construction charge.
METER SET INFORMATION
 For single-family residential homes, Consumers Energy will install the gas meter within 5 business days of the service installation. It is not necessary for
you to call to request the meter. It will not be necessary for Consumers Energy to gain access to the home nor does the fuel line have to be tied into the
meter bracket. The gas meter will be set and a short piece of piping with a closed brass valve will be attached to the back of the meter for your fuel line
connection point. You can then schedule your mechanical contractor at a convenient time to connect the fuel line and turn on the appliances. If however,
your fuel lines are tied into the bracket prior to the meter set, Consumers Energy will need access to the home. NOTE: The monthly meter charge of
$11.50 will begin when the meter is set.
 If, however, the home’s gas consumption requires a larger capacity meter, is a mobile home, or a multi-family dwelling with multi meter stands, it will be
necessary to call 1-800-477-5050 to have your meter installed. Your fuel lines must be tied into the meter bracket and at least one gas appliance must be
connected. Consumers Energy must have access to the home for the meter to be completed. Advance notice of 48 hours is appreciated.
FINAL RESTORATION
 After gas service is installed, excavation will be backfilled. Final restoration is your responsibility.
SPECIAL NOTES
 Consumers Energy reserves the right to deny or terminate service to any customer who elects use of an alternate natural or well gas source.
 When converting from bottled gas, natural gas must be used exclusively on the premise.
 When converting from other fuels, your gas service should be installed before removing existing equipment.
Form 1241 11-2015
Page 3 of 3