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. Requestor (Please 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 (Please enter the Legal Company Name that will be used as the counter party for any Contracts/Agreements created with TransGas. Note: This address will be used for future legal notices for the life of any assets covered by Agreements and not just for the initial installation. Notices Attention are suggested to be departments and not individuals. Example: Land Dept, Legal, etc.) Legal Company Name Notices Attention Mailing Address City Province Postal Code Email Phone Grantee Field Contact (Please 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 or Encroachment Notices) Company Name Phone Email Land Location (Please 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 1/4 Section Township Range Meridian Lot Block Plan Latitude Longitude Activities Planned (please select all that apply to your work) Fencing Fencing Options Wood Post Steep Post Other Ground Disturbance (digging near pipeline or work within TGL ROW, ex. planting trees) Buried Cable Crossing (please indicate the number of cables) Telephone Cable Power Fiber Other Voltage Above Ground Cable Crossing Voltage Ground disturbance within 100m of a marked TGL cathodic facility (if known) Ground disturbance within 30m of a TGL rectifier (if known) Culvert Diameter (mm) New Pipeline Construction Pipelines Pipelines Pipe Size (mm) Pipe Material Product Carried Seismic (please include map of proposed program area) Well New Permanent Road Construction Paved Gravel Rail Crossing Vehicle / Equipment Crossing 1) Select yes if you will be crossing with tractor trailer units and/or smaller vehicles that meet legal Provincial road weights that require no special permits Yes No 2) Please list any additional specific equipment that you require to cross our pipeline with 2) Please list any additional specific equipment that you require to cross our pipeline with Equipment - Make and Model Gross Loaded Weight (lbs.) Equipment - Make and Model Gross Loaded Weight (lbs.) Equipment - Make and Model Gross Loaded Weight (lbs.) Equipment - Make and Model Gross Loaded Weight (lbs.) Description of Work Activity Planned (please attach drawings with application) Attachments Attachments 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 permits are issued. 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
