Get Adobe Flash player

Gas Forms

VILLAGE OF WESTVILLE

 

EXCESS FLOW VALVE

 

CUSTOMER NOTIFICATION

 

                                                                                      

DATE                                      SIGNATURE

 

 

       I have reviewed the above notification and understand the information provided.

 

1)   I request that an excess flow valve be installed on my service line.

 

                                                                                      

DATE                                            SIGNATURE

 

2)   I request that an excess flow valve not be installed on my service line.

 

                                                                                      

DATE                                            SIGNATURE

 

 

SERVICE ADDRESS:

 

ACCOUNT NO.:


WESTVILLE GAS & WATER

201 North State Street – City Hall

WESTVILLE, ILLINOIS  61883

 

Phone (217) 267-7911

 

 

GAS SERVICE INFORMATION

 

The Customer is responsible to run their side of gas line from outlet of meter.

 

This must be steel pipe.  No copper or other materials allowed.  Coated flex connections are allowed on stoves, dryers, or other appliances if approved by the manufacturer.

 

Minimum of 1”.

 

The gas line should not be underground.

 

No electric lines are allowed connected to gas or water lines.

 

IF CUSTOMER DOES RUN PIPE UNDERGROUND:

 

Owner must be aware that it should be coated pipe.

 

It should be cathodicly protected.

 

It should be leaked surveyed periodically.

 

The Gas & Water Department is not responsible for the customer’s side of service.

 

No one except authorized employees are allowed to turn on or shut off gas at the meter.

 

For more information please contact the Gas & Water Office.

 

Thank You.

 

                                                                                                                       

SUPERINTENDENT                                            CUSTOMER SIGNATURE

                                                                                                                       

                                                                      DATE

1 copy to owner                                                                                                 

1 copy for our records                                       PHONE

                                                                                                                       

                                                                      ADDRESS


WESTVILLE GAS & WATER

201 North State Street – City Hall

WESTVILLE, ILLINOIS  61883

 

Phone (217) 267-7911

 

 

ESTIMATED COST OF NEW GAS HOOK-UP EFFECTIVE 01-08-97

 

                                                                                                                                 

NAME                      CURRENT ADDRESS                                         PHONE

 

                                                                                                                                 

ADDRESS OF NEW SERVICE

 

¾ steel gas pipe @ $3.50 per foot to house approximate footage                                

 

Gas meter @ $145.00 each                                                                                         

 

Welders Fee

          (Average welders time per service.  Approximately 3 to 4 hours.

          Not to exceed 4 hours unless otherwise stipulated.)

          The welders are contracted out by the Village Gas Department.

          The total bill will be borne by the owner.

          Average welding fee $350.00.                                                                           

 

 

NOTE:

          The above represents an estimated cost.

          The actual charge may be somewhat higher or lower.

 

 

                                                                                                                                 

SUPERINTENDENT                                           CUSTOMERS NAME

WESTVILLE GAS & WATER SYSTEMS

 

                                                                                                                                 

DATE                                                              DATE


WESTVILLE GAS & WATER

201 North State Street – City Hall

WESTVILLE, ILLINOIS  61883

 

Phone (217) 267-7911

 

 

ESTIMATED COST OF NEW WATER HOOK-UP EFFECTIVE 01-08-97

 

                                                                                                                                 

NAME                      CURRENT ADDRESS                                           PHONE

 

                                                                                                                                 

ADDRESS OF NEW SERVICE

 

$450.00 MINIMUM                                                                                                        

This includes:

          Tap

          Meter

          Meter well

          Lid & bonnet

          Meter outlet

          Meter angle valve

          35 ft. (or less) of ¾” copper

          After 35 ft. of copper $2.25 per foot                                                                       

 

The Village will run a service line approximately 5 ft. past property line (or there about) in a location that will not be located in a driveway or sidewalk.

 

The customer shall install his line from meter into their home.

 

This must be ¾” K copper.

 

If customer wants plastic waterline, it shall be 200 psi or greater.  The customer shall notify the water company of this.  The Westville Gas & Water Company will then run a piece of copper out of meter to make connection to plastic outside of meter well.

 

The Village does not allow plastic pipe to be hooked directly to meter.

 

For more information please contact the Gas & Water office.

 

Thank you.

 

 

Superintendent

 

CUSTOMER SIGNATURE                                                  TOTAL                                      

DATE                                                                                                                          

 

WESTVILLE, ILLINOIS

 

APPLICATION FOR GAS SYSTEM SERVICE CONNECTION

 

 

            The undersigned, representing himself as owner of the property located at                                                                                                                                   , hereby makes application for connection to the Gas System of the Village for said property, and in consideration of the furnishing of said service covenants and agrees as follows:

 

1.         I agree to abide by all rules and regulations as specified in and by the ordinances of the Village now in effect or enacted and passed from time to time providing for the regulation of said gas system or specifying fees and rates to be charged for connection and gas service furnished by the Village, it is further acknowledged and agreed that the undersigned, his heirs, executors, administrators, successors and assigns shall pay all charges for connection fees and gas usage which shall become due as the result of the connecting of the gas mains and the furnishing of gas service to the above property, and that all such charges and fees for gas service rendered to the property, together with penalties, if any, and the costs of collection are to be considered and become a charge against the property, the lien so created to be enforced in accordance with the ordinances of the Village.

2.         All bills for the aforesaid charges are payable within fifteen (15) days following the receipt of said bill and if not paid, are subject to a penalty of ten percent (10%) as provided in the Utilities Code (Chapter 38).

3.         Each and all of the agreements and covenants herein contained shall run with the real estate above described whose present owner is signatory to this application.

4.         I understand that after making this application, I am to await installation permit and instructions therewith.

5.         SERVICE CONNECTION FEE:  $ ___________ shall be paid upon installation to the Westville Gas and Water.

6.         Permission is hereby granted to the Village and its authorized representatives at any reasonable time to enter the premises of the applicant and any portion thereof for the purposes of inspecting all connections appurtenant to the Gas System.

7.         Customer is required to have one (1) inch steel pipe from outlet of meter into house with shut offs on all appliances.

8.         No one except WESTVILLE GAS AND WATER PERSONNEL shall be allowed to turn on or turn off gas at meter.

 

 

SIGNATURE:                                                                                                                                          

 

                                                                                                                                                           

                                                                                    (STREET NUMBER AND NAME OF STREET)

 

                                                                                                                                                           

                                                                                    (VILLAGE, STATE AND ZIP CODE)

 

                                                                                                                                                           

                                                                                    (TELEPHONE NUMBER)                             (DATE)

 

-----------------------------------------------------------------------------------------------------------------------------------------------

                                                                                    (

Do not fill in the                            MAIL BILLS TO:               (                                                                      

spaces to the right                                                            (NAME)

if the information                                                              (                                                                      

is the same as the                                                            (STREET NUMBER AND NAME OF STREET)

applicant above.                                                               (

                                                                                    (                                                                      

                                                                                    (VILLAGE, STATE AND ZIP CODE)

 

-----------------------------------------------------------------------------------------------------------------------------------------------