City Clearance

This online form is used by city/county officials to notify Dominion Energy when a clearance permit is issued approving a gas-meter set at a premises within the city/county's jurisdiction.

	* - required fields
Date:	(Ex: MM/DD/YYYY)
Submitting City/County:	*
Phone Number:
Submitter's Email:	*		(confirmation number sent to this address)
Premises Info
Street address:	*
City:	*
Subdivision:
Lot:
Owner/Builder:	*
Is This a Multiple Meter?:	Yes No
If Yes, are Fuel lines tagged?:	Yes No	N/A
Fuel-line size:
Load (CFH/BTU):	Load Type:
Pressure:
Permit #:
Building Inspector:
Comments: