Instructions: Complete one application form for each 1/4 section of land affected. Please include drawings of your proposed work relative to the TransGas natural gas line right-of-way with your application. Drawings of your entire project are not required. Note: required fields are indicated with an asterisk (*) Requestor Enter the information of the party you want the Agreements and/or replies to be sent. Company First Name Last Name Email Phone Your Reference #? Grantee/Owner Enter the individual or legal company name for whom the work is being completed. This will be used as the counter party for any Contracts/Agreements with TransGas and also for future legal notices for the life of any assets covered by the Agreements, not just for initial installation. Legal Company Name Notices Attention Mailing Address City Province Postal Code Email Phone Grantee Field Contact Enter the information of the Field Contact you want TransGas to notify in future years when entering the joint crossing area covered by any Agreements issued. This information is not required for Seismic Notices. Company Name Email Phone Land Location Enter the legal land location of the work you are proposing. Note: one application required per 1/4 section or land parcel affected. LSD or Quarter Section Township Range Meridian Lot Block Plan Latitude Longitude Activities Planned Select all that apply. Fencing Fence Type SelectWood PostSteel PostOther Ground Disturbance? Buried Cable Crossing Indicate the number of cables: Telephone Cable Power Fiber Other Voltage Above Ground Cable Crossing Voltage Is your work within 30 metres of a TransGas cathodic facility (ie. rectifier or ground bed)? SelectYesNoUnsure Culvert Diameter (mm) New Pipeline Construction Pipelines Pipelines Pipe Size (mm) Pipe Material Product Carried Seismic Include a map of the proposed program area in the attachments. Well Include a drawing indicating the distance from the gas line or right-of-way in the attachments. New Permanent Road Construction Surface SelectPavedGravel Include a new road crossing profile in the attachments. Rail Crossing Include a new rail crossing profile in the attachments. Temporary Vehicle / Equipment Crossing List all vehicles and equipment you require as part of your project. List all vehicles and equipment you require as part of your project. Equipment - Make and Model Gross Loaded Weight (lbs.) Does the vehicle have wheels or tracks? SelectWheelsTracks Are vehicles highway legal without special permits? SelectYesNo Describe the type of work activity planned Attachments Include drawings or sketches to show work and indicate the distance to the TransGas facility or pipeline. Include drawings Unlimited number of files can be uploaded to this field.10 MB limit.Allowed types: GIF, JPG, JPEG, DOC, DOCX, BMP, PDF, PNG, PPT, PPTX, XLS, XLSX, VSD, DWG, DXR, DWF, TIF, TIFF. Acknowledgement TransGas will review your application for completeness and effect on TransGas infrastructure. If safe to do so, TransGas will issue a permit to cover the requested activities or will contact you if the work activities cannot proceed. Work MUST NOT proceed until signed contracts are in place. TransGas uses DocuSign to acquire contract signatures and to issue executed contracts. By selecting “I agree”, you acknowledge and agree the information provided is accurate and complete; are an authorized agent to make this request; acknowledge and agree to the use, collection, storage and retention of your personal information, and any other information you provide with this form in accordance with our Privacy Policy as applicable; accept that it is your responsibility to notify TransGas of any changes to the information provided. I Agree
