This form is not a binding contract for natural gas service.  We will use this information to document community interest in having Dominion Energy bring natural gas to your community, and to keep you informed as we explore options together to provide natural gas service to North Rock Springs.  

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* 1. Please fill out the information below regarding potential natural gas service in North Rock Springs, Wyoming.

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* 2. Are you interested in natural gas service at your home?

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* 2a. Please explain.

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* 3. What is the square footage of your home?

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* 4. Do you own or rent your home?

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* 5. What is your current source of space heating?

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* 6. What appliances do you currently have in your home?

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* 7. If you have propane, is the fuel line black pipe or copper pipe?

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* 8. If you have propane, is the fuel line in the front or back of your home?

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* 9. What are your annual energy costs to heat your home and water?

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* 10. Would you sign up for natural gas service for an annual cost of approximately $1,350*?
*Based on a typical Wyoming customer using 90 dekatherms per year

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* 11. What do you see as the benefits of having natural gas in North Rock Springs? (optional)

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* 12. What questions do you have about natural gas service at your home? (optional)

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