{"id":33260,"date":"2017-10-11T22:22:49","date_gmt":"2017-10-12T02:22:49","guid":{"rendered":"http:\/\/www.snew.org\/?page_id=33260"},"modified":"2017-11-26T20:59:36","modified_gmt":"2017-11-27T01:59:36","slug":"application-for-new-or-modified-water-service","status":"publish","type":"page","link":"https:\/\/www.snew.org\/forms\/application-for-new-or-modified-water-service\/","title":{"rendered":"Application for New or Modified Water Service"},"content":{"rendered":"<p><a href=\"https:\/\/www.snew.org\/wp-content\/uploads\/App-for-new-or-modified-water-service.pdf\" target=\"_blank\" rel=\"noopener\">Printable Form, New or Modified Water Service Application Form (PDF)<\/a><\/p>\n<h3>Related Documents<\/h3>\n<ul>\n<li><a href=\"https:\/\/www.snew.org\/wp-content\/uploads\/standard-meter-pit-configuration.pdf\" target=\"_blank\" rel=\"noopener\">Standard Meter Pit Configuration Form (PDF)<\/a><\/li>\n<li><a href=\"https:\/\/www.snew.org\/wp-content\/uploads\/tap-permit-application.pdf\" target=\"_blank\" rel=\"noopener\">Tap Permit Application Form (PDF)<\/a><\/li>\n<\/ul>\n<p>Please fill out the application completely. The tap permit must be signed by the owner of record and notarized. Both forms must be returned along with a plot plan before any calculations will be performed.<\/p>\n<script type=\"text\/javascript\">\n\/\/----------------------------------------------------------\n\/\/------ JAVASCRIPT HOOK FUNCTIONS FOR GRAVITY FORMS -------\n\/\/----------------------------------------------------------\n\nif ( ! gform ) {\n\tdocument.addEventListener( 'gform_main_scripts_loaded', function() { gform.scriptsLoaded = true; } );\n\twindow.addEventListener( 'DOMContentLoaded', function() { gform.domLoaded = true; } );\n\n\tvar gform = {\n\t\tdomLoaded: false,\n\t\tscriptsLoaded: false,\n\t\tinitializeOnLoaded: function( fn ) {\n\t\t\tif ( gform.domLoaded && gform.scriptsLoaded ) {\n\t\t\t\tfn();\n\t\t\t} else if( ! gform.domLoaded && gform.scriptsLoaded ) {\n\t\t\t\twindow.addEventListener( 'DOMContentLoaded', fn );\n\t\t\t} else {\n\t\t\t\tdocument.addEventListener( 'gform_main_scripts_loaded', fn );\n\t\t\t}\n\t\t},\n\t\thooks: { action: {}, filter: {} 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target='gform_ajax_frame_6' id='gform_6'  action='\/wp-json\/wp\/v2\/pages\/33260#gf_6' data-formid='6' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_6' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_6_26\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_26\"><label class='gfield_label gform-field-label' for='input_6_26' >Date:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_26' id='input_6_26' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_6_26_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_26_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_26' class='gform_hidden' value='https:\/\/www.snew.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_6_27\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_27\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Property Owner&#039;s Name Currently Recorded with Town Clerk<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_6_27'>\n                            \n                            <span id='input_6_27_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_27.3' id='input_6_27_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_27_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            <span id='input_6_27_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_27.4' id='input_6_27_4' value=''   aria-required='false'     \/>\n                                                    <label for='input_6_27_4' class='gform-field-label gform-field-label--type-sub '>Middle<\/label>\n                                                <\/span>\n                            <span id='input_6_27_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_27.6' id='input_6_27_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_27_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_6\"  class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_6\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Location<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_6_6' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_6_6_1_container' >\n                                        <input type='text' name='input_6.1' id='input_6_6_1' value=''    aria-required='true'    \/>\n                                        <label for='input_6_6_1' id='input_6_6_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_6_6_2_container' >\n                                        <input type='text' name='input_6.2' id='input_6_6_2' value=''     aria-required='false'   \/>\n                                        <label for='input_6_6_2' id='input_6_6_2_label' class='gform-field-label gform-field-label--type-sub '>Tax Lot No.; Block; and District required<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_6_6_3_container' >\n                                    <input type='text' name='input_6.3' id='input_6_6_3' value=''    aria-required='true'    \/>\n                                    <label for='input_6_6_3' id='input_6_6_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_6_6_4_container' >\n                                        <select name='input_6.4' id='input_6_6_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' selected='selected'>Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_6_6_4' id='input_6_6_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_6_6_5_container' >\n                                    <input type='text' name='input_6.5' id='input_6_6_5' value=''    aria-required='true'    \/>\n                                    <label for='input_6_6_5' id='input_6_6_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_6.6' id='input_6_6_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_6_43\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_43\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Applicant&#039;s Name (Same if Owner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_6_43'>\n                            \n                            <span id='input_6_43_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_43.3' id='input_6_43_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_43_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            <span id='input_6_43_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_43.4' id='input_6_43_4' value=''   aria-required='false'     \/>\n                                                    <label for='input_6_43_4' class='gform-field-label gform-field-label--type-sub '>Middle<\/label>\n                                                <\/span>\n                            <span id='input_6_43_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_43.6' id='input_6_43_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_43_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_42\"  class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_42\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Applicant&#039;s Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_6_42' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_6_42_1_container' >\n                                        <input type='text' name='input_42.1' id='input_6_42_1' value=''    aria-required='true'    \/>\n                                        <label for='input_6_42_1' id='input_6_42_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_6_42_2_container' >\n                                        <input type='text' name='input_42.2' id='input_6_42_2' value=''     aria-required='false'   \/>\n                                        <label for='input_6_42_2' id='input_6_42_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_6_42_3_container' >\n                                    <input type='text' name='input_42.3' id='input_6_42_3' value=''    aria-required='true'    \/>\n                                    <label for='input_6_42_3' id='input_6_42_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_6_42_4_container' >\n                                        <select name='input_42.4' id='input_6_42_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' selected='selected'>Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_6_42_4' id='input_6_42_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_6_42_5_container' >\n                                    <input type='text' name='input_42.5' id='input_6_42_5' value=''    aria-required='true'    \/>\n                                    <label for='input_6_42_5' id='input_6_42_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_42.6' id='input_6_42_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_6_8\"  class=\"gfield gfield--type-phone gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_8\"><label class='gfield_label gform-field-label' for='input_6_8' >Home Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_8' id='input_6_8' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_45\"  class=\"gfield gfield--type-phone gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_45\"><label class='gfield_label gform-field-label' for='input_6_45' >Business Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_45' id='input_6_45' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_37\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_37\"><h2 class=\"gsection_title\">Service<\/h2><\/li><li id=\"field_6_39\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_3col gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_39\"><label class='gfield_label gform-field-label'  >Application is For<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_39'>\n\t\t\t<li class='gchoice gchoice_6_39_0'>\n\t\t\t\t<input name='input_39' type='radio' value='New Service'  id='choice_6_39_0'    \/>\n\t\t\t\t<label for='choice_6_39_0' id='label_6_39_0' class='gform-field-label gform-field-label--type-inline'>New Service<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_39_1'>\n\t\t\t\t<input name='input_39' type='radio' value='Modification of Existing'  id='choice_6_39_1'    \/>\n\t\t\t\t<label for='choice_6_39_1' id='label_6_39_1' class='gform-field-label gform-field-label--type-inline'>Modification of Existing<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_39_2'>\n\t\t\t\t<input name='input_39' type='radio' value='Renewal of Existing'  id='choice_6_39_2'    \/>\n\t\t\t\t<label for='choice_6_39_2' id='label_6_39_2' class='gform-field-label gform-field-label--type-inline'>Renewal of Existing<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_40\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_3col gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_40\"><label class='gfield_label gform-field-label'  >Type of Service<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_40'>\n\t\t\t<li class='gchoice gchoice_6_40_0'>\n\t\t\t\t<input name='input_40' type='radio' value='Single Family\u00b9'  id='choice_6_40_0'    \/>\n\t\t\t\t<label for='choice_6_40_0' id='label_6_40_0' class='gform-field-label gform-field-label--type-inline'>Single Family\u00b9<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_40_1'>\n\t\t\t\t<input name='input_40' type='radio' value='Two Family Structure\u00b9'  id='choice_6_40_1'    \/>\n\t\t\t\t<label for='choice_6_40_1' id='label_6_40_1' class='gform-field-label gform-field-label--type-inline'>Two Family Structure\u00b9<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_40_2'>\n\t\t\t\t<input name='input_40' type='radio' value='Multiple Family\u00b2'  id='choice_6_40_2'    \/>\n\t\t\t\t<label for='choice_6_40_2' id='label_6_40_2' class='gform-field-label gform-field-label--type-inline'>Multiple Family\u00b2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_40_3'>\n\t\t\t\t<input name='input_40' type='radio' value='Business - Commerical\u00b2'  id='choice_6_40_3'    \/>\n\t\t\t\t<label for='choice_6_40_3' id='label_6_40_3' class='gform-field-label gform-field-label--type-inline'>Business - Commerical\u00b2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_40_4'>\n\t\t\t\t<input name='input_40' type='radio' value='Office\u00b2'  id='choice_6_40_4'    \/>\n\t\t\t\t<label for='choice_6_40_4' id='label_6_40_4' class='gform-field-label gform-field-label--type-inline'>Office\u00b2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_40_5'>\n\t\t\t\t<input name='input_40' type='radio' value='Manufacturing\u00b2'  id='choice_6_40_5'    \/>\n\t\t\t\t<label for='choice_6_40_5' id='label_6_40_5' class='gform-field-label gform-field-label--type-inline'>Manufacturing\u00b2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_40_6'>\n\t\t\t\t<input name='input_40' type='radio' value='Heavy Industrial\u00b2'  id='choice_6_40_6'    \/>\n\t\t\t\t<label for='choice_6_40_6' id='label_6_40_6' class='gform-field-label gform-field-label--type-inline'>Heavy Industrial\u00b2<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_6_40'><strong>Notes:<\/strong> <br>\n1) A-2 certified Plot plan MUST accompany applications.<br>\n2) A-2 ceritified Plot and detailed site and utility plans MUST accompany applications. <\/div><\/li><li id=\"field_6_41\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_41\"><h2 class=\"gsection_title\">Architect, Engineer, Designer<\/h2><\/li><li id=\"field_6_44\"  class=\"gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_44\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Name of Architect, engineer, Designer (if applicable)<\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_6_44'>\n                            \n                            <span id='input_6_44_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_44.3' id='input_6_44_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_6_44_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            <span id='input_6_44_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_44.4' id='input_6_44_4' value=''   aria-required='false'     \/>\n                                                    <label for='input_6_44_4' class='gform-field-label gform-field-label--type-sub '>Middle<\/label>\n                                                <\/span>\n                            <span id='input_6_44_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_44.6' id='input_6_44_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_6_44_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_28\"  class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_28\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Address of Architect, engineer, Designer (if applicable)<\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_6_28' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_6_28_1_container' >\n                                        <input type='text' name='input_28.1' id='input_6_28_1' value=''    aria-required='false'    \/>\n                                        <label for='input_6_28_1' id='input_6_28_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_6_28_2_container' >\n                                        <input type='text' name='input_28.2' id='input_6_28_2' value=''     aria-required='false'   \/>\n                                        <label for='input_6_28_2' id='input_6_28_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_6_28_3_container' >\n                                    <input type='text' name='input_28.3' id='input_6_28_3' value=''    aria-required='false'    \/>\n                                    <label for='input_6_28_3' id='input_6_28_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_6_28_4_container' >\n                                        <select name='input_28.4' id='input_6_28_4'     aria-required='false'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' selected='selected'>Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_6_28_4' id='input_6_28_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_6_28_5_container' >\n                                    <input type='text' name='input_28.5' id='input_6_28_5' value=''    aria-required='false'    \/>\n                                    <label for='input_6_28_5' id='input_6_28_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_28.6' id='input_6_28_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_6_36\"  class=\"gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_36\"><label class='gfield_label gform-field-label' for='input_6_36' >Phone of Architect, engineer, Designer (if applicable)<\/label><div class='ginput_container ginput_container_phone'><input name='input_36' id='input_6_36' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_46\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_46\"><h2 class=\"gsection_title\">Choice Service<\/h2><\/li><li id=\"field_6_47\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_47\"><label class='gfield_label gform-field-label'  >Type of Service Required<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_47'>\n\t\t\t<li class='gchoice gchoice_6_47_0'>\n\t\t\t\t<input name='input_47' type='radio' value='Domestic Only (including Process Water)'  id='choice_6_47_0'    \/>\n\t\t\t\t<label for='choice_6_47_0' id='label_6_47_0' class='gform-field-label gform-field-label--type-inline'>Domestic Only (including Process Water)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_47_1'>\n\t\t\t\t<input name='input_47' type='radio' value='Fire Only'  id='choice_6_47_1'    \/>\n\t\t\t\t<label for='choice_6_47_1' id='label_6_47_1' class='gform-field-label gform-field-label--type-inline'>Fire Only<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_47_2'>\n\t\t\t\t<input name='input_47' type='radio' value='Fire and Domestic Separate'  id='choice_6_47_2'    \/>\n\t\t\t\t<label for='choice_6_47_2' id='label_6_47_2' class='gform-field-label gform-field-label--type-inline'>Fire and Domestic Separate<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_47_3'>\n\t\t\t\t<input name='input_47' type='radio' value='Fire and Domestic Combined'  id='choice_6_47_3'    \/>\n\t\t\t\t<label for='choice_6_47_3' id='label_6_47_3' class='gform-field-label gform-field-label--type-inline'>Fire and Domestic Combined<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_48\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_48\"><h2 class=\"gsection_title\">FIRE SERVICES<\/h2><\/li><li id=\"field_6_50\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_50\"><label class='gfield_label gform-field-label' for='input_6_50' >GPM required<\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_6_50' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_51\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_51\"><label class='gfield_label gform-field-label' for='input_6_51' >psi residual<\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_6_51' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_52\"  class=\"gfield gfield--type-checkbox gfield--type-choice gf_list_4col field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_52\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Type:<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_6_52'><li class='gchoice gchoice_6_52_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.1' type='checkbox'  value='Wet'  id='choice_6_52_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_52_1' id='label_6_52_1' class='gform-field-label gform-field-label--type-inline'>Wet<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_52_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.2' type='checkbox'  value='Dry'  id='choice_6_52_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_52_2' id='label_6_52_2' class='gform-field-label gform-field-label--type-inline'>Dry<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_52_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.3' type='checkbox'  value='Antifreeze'  id='choice_6_52_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_52_3' id='label_6_52_3' class='gform-field-label gform-field-label--type-inline'>Antifreeze<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_52_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.4' type='checkbox'  value='Foam'  id='choice_6_52_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_52_4' id='label_6_52_4' class='gform-field-label gform-field-label--type-inline'>Foam<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_53\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_53\"><label class='gfield_label gform-field-label' for='input_6_53' >Yard Hydrants No.:<\/label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_6_53' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_54\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_54\"><label class='gfield_label gform-field-label' for='input_6_54' >Yard Hydrants Type:<\/label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_6_54' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_55\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_55\"><label class='gfield_label gform-field-label' for='input_6_55' >Other:<\/label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_6_55' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_49\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_49\"><h2 class=\"gsection_title\">Fixtures<\/h2><\/li><li id=\"field_6_57\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_57\"><label class='gfield_label gform-field-label' for='input_6_57' >Toilets Flush Valve No.<\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_6_57' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_58\"  class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_58\"><label class='gfield_label gform-field-label' for='input_6_58' >Toilets Flush Valve Inlet Size<\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_6_58' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_59\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_59\"><label class='gfield_label gform-field-label' for='input_6_59' >Toilets Tank Type No.<\/label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_6_59' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_60\"  class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_60\"><label class='gfield_label gform-field-label' for='input_6_60' >Toilets Tank Type Inlet Size<\/label><div class='ginput_container ginput_container_text'><input name='input_60' id='input_6_60' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_61\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_61\"><label class='gfield_label gform-field-label' for='input_6_61' >Shower Stalls No.<\/label><div class='ginput_container ginput_container_text'><input name='input_61' id='input_6_61' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_62\"  class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_62\"><label class='gfield_label gform-field-label' for='input_6_62' >Shower Stalls Inlet Size<\/label><div class='ginput_container ginput_container_text'><input name='input_62' id='input_6_62' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_63\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_63\"><label class='gfield_label gform-field-label' for='input_6_63' >Bath Tubs No.<\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_6_63' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_64\"  class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_64\"><label class='gfield_label gform-field-label' for='input_6_64' >Bath Tubs Inlet Size<\/label><div class='ginput_container ginput_container_text'><input name='input_64' id='input_6_64' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_65\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_65\"><label class='gfield_label gform-field-label' for='input_6_65' >Shower\/Bath comb No.<\/label><div class='ginput_container ginput_container_text'><input name='input_65' id='input_6_65' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_66\"  class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_66\"><label class='gfield_label gform-field-label' for='input_6_66' >Shower\/Bath comb Inlet Size<\/label><div class='ginput_container ginput_container_text'><input name='input_66' id='input_6_66' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_67\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_67\"><label class='gfield_label gform-field-label' for='input_6_67' >Lav Sinks No.<\/label><div class='ginput_container ginput_container_text'><input name='input_67' id='input_6_67' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_68\"  class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_68\"><label class='gfield_label gform-field-label' for='input_6_68' >Lav Sinks Inlet Size<\/label><div class='ginput_container ginput_container_text'><input name='input_68' id='input_6_68' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_69\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_69\"><label class='gfield_label gform-field-label' for='input_6_69' >Kitchen Sinks No.<\/label><div class='ginput_container ginput_container_text'><input name='input_69' id='input_6_69' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_70\"  class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_70\"><label class='gfield_label gform-field-label' for='input_6_70' >Kitchen Sinks Inlet Size<\/label><div class='ginput_container ginput_container_text'><input name='input_70' id='input_6_70' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_71\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_71\"><label class='gfield_label gform-field-label' for='input_6_71' >Clothes Washers No.<\/label><div class='ginput_container ginput_container_text'><input name='input_71' id='input_6_71' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_72\"  class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_72\"><label class='gfield_label gform-field-label' for='input_6_72' >Clothes Washers Inlet Size<\/label><div class='ginput_container ginput_container_text'><input name='input_72' id='input_6_72' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_73\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_73\"><label class='gfield_label gform-field-label' for='input_6_73' >Dishwashers No.<\/label><div class='ginput_container ginput_container_text'><input name='input_73' id='input_6_73' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_74\"  class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_74\"><label class='gfield_label gform-field-label' for='input_6_74' >Dishwashers Inlet Size<\/label><div class='ginput_container ginput_container_text'><input name='input_74' id='input_6_74' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_75\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_75\"><label class='gfield_label gform-field-label' for='input_6_75' >Hose Connections No.<\/label><div class='ginput_container ginput_container_text'><input name='input_75' id='input_6_75' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_76\"  class=\"gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_76\"><label class='gfield_label gform-field-label' for='input_6_76' >Hose Connections Inlet Size<\/label><div class='ginput_container ginput_container_text'><input name='input_76' id='input_6_76' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_78\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_78\"><label class='gfield_label gform-field-label'  >City Sewer<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_78'>\n\t\t\t<li class='gchoice gchoice_6_78_0'>\n\t\t\t\t<input name='input_78' type='radio' value='Yes'  id='choice_6_78_0'    \/>\n\t\t\t\t<label for='choice_6_78_0' id='label_6_78_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_78_1'>\n\t\t\t\t<input name='input_78' type='radio' value='No'  id='choice_6_78_1'    \/>\n\t\t\t\t<label for='choice_6_78_1' id='label_6_78_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_79\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_79\"><label class='gfield_label gform-field-label'  >Basement<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_79'>\n\t\t\t<li class='gchoice gchoice_6_79_0'>\n\t\t\t\t<input name='input_79' type='radio' value='Yes'  id='choice_6_79_0'    \/>\n\t\t\t\t<label for='choice_6_79_0' id='label_6_79_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_79_1'>\n\t\t\t\t<input name='input_79' type='radio' value='No'  id='choice_6_79_1'    \/>\n\t\t\t\t<label for='choice_6_79_1' id='label_6_79_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_81\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_81\"><label class='gfield_label gform-field-label'  >Existing Well<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_81'>\n\t\t\t<li class='gchoice gchoice_6_81_0'>\n\t\t\t\t<input name='input_81' type='radio' value='Yes'  id='choice_6_81_0'    \/>\n\t\t\t\t<label for='choice_6_81_0' id='label_6_81_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_81_1'>\n\t\t\t\t<input name='input_81' type='radio' value='No'  id='choice_6_81_1'    \/>\n\t\t\t\t<label for='choice_6_81_1' id='label_6_81_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_80\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_80\"><label class='gfield_label gform-field-label'  >Boiler Corrosion Inhibitor<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_80'>\n\t\t\t<li class='gchoice gchoice_6_80_0'>\n\t\t\t\t<input name='input_80' type='radio' value='Yes'  id='choice_6_80_0'    \/>\n\t\t\t\t<label for='choice_6_80_0' id='label_6_80_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_80_1'>\n\t\t\t\t<input name='input_80' type='radio' value='No'  id='choice_6_80_1'    \/>\n\t\t\t\t<label for='choice_6_80_1' id='label_6_80_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_82\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_82\"><label class='gfield_label gform-field-label' for='input_6_82' >Bldg. 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Line.<\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_6_82' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_83\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_83\"><label class='gfield_label gform-field-label' for='input_6_83' >Comments, Explanations and Other Fixtures (Process, Cooling, Inground pool, Lawn Sprinklers, Etc.)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_83' id='input_6_83' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_6' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;}  jQuery(\"#gform_6\").trigger(\"submit\",[true]); }' \/> <input type='hidden' name='gform_ajax' value='form_id=6&amp;title=&amp;description=1&amp;tabindex=0&amp;theme=data-form-theme=&#039;legacy&#039;' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_6' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='6' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_6' value='WyJbXSIsImRkMWVjNTc5YjhhNjc5YThjMTQyMjFkODYyNjk2ZmRkIl0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_6' id='gform_target_page_number_6' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_6' id='gform_source_page_number_6' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\n\t\t                <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_6' id='gform_ajax_frame_6' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'><\/iframe>\n\t\t                <script type=\"text\/javascript\">\ngform.initializeOnLoaded( function() {gformInitSpinner( 6, 'https:\/\/www.snew.org\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_6').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_6');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_6').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! 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