C.F No.21

Cost of Form Rs.25/-

No.

Application form for New Water Supply Connection.

Name of the Plumber to whom work allotted:

License No:

Address:

1. Date of Issue of Application:

2. Name and Address of the Applicant:

3. Address to which communication to be sent:

Details to be collected from Town Planning Section 

a. Details of Building Plan approval:

b. Details of Deviation:

c. Installation license No. (if it is industries):

d. Age of the building:

e. Details of development charges collected on unapproved layouts / sites:

f. Details of appeal plan received:

g. If temporary connection is recommended period may be specified:

T.P.I

A.T.P.O

C.T.P.O

Details to be collected from the Revenue Section 

a. Assessment No:

b. A.R.V:

c. Tax:

d. Name of the Owner:

e. Division No:

f. Door No:

g. Details of Tax to be paid:

L.I                            

A.R.O         

Water supply section 

Details of well water tax arrears.

Acct / WS     

Note: The Plumber should submit the estimate after collecting the particulars from the concerned section to the Corporation office before ......