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Water Supply Connection Application Form

This document is an application form for a water supply connection from the Municipal Corporation of Chandigarh. It includes details about the applicant, the premises, plumbing works, and the costs associated with the connection. The form requires signatures from the applicant and the licensed plumber, and outlines the responsibilities and agreements related to the water supply connection.

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manishh49805525
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62 views2 pages

Water Supply Connection Application Form

This document is an application form for a water supply connection from the Municipal Corporation of Chandigarh. It includes details about the applicant, the premises, plumbing works, and the costs associated with the connection. The form requires signatures from the applicant and the licensed plumber, and outlines the responsibilities and agreements related to the water supply connection.

Uploaded by

manishh49805525
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

SCHEDULE-A

APPLICATION FORM FOR A CONNECTION FOR WATER SUPPLY FROM THE


DISTRIBUNTION MAINS OF THE MUNICIPAL CORPORATION CHANDIGARH.

PRESENTED BY

Name ……………………………………………..

Address …………………………………………..

……………………………………………
I/ We the undersigned hereby make application to the premises and the purpose described below
and agree to pay such charges as the Chief Administrator may from time to time be entitled to make.

I/We undertake to act in respect of the side supply in a enormity with the bye-laws and
regulations make by the Chief Administrator and with such amended bye-laws and regulations as may be
made from time to time.

I/We agree that the Chief Administrator shall with or without notice have powers to close or over
at any time the private/ commencement to may house on promise if he considers it advisable or
necessary to for any reason whatsoever.

Sh. ……………………………………………. Licensed plumber has been instructed


by………………………………… to carry out the plumbing works.

Signature of applicant
and owner (or her recognized agent)
or house or premises.
Description of premises :-

House No. ……………………..… is situated, Sector …………………………... Particulars of connection.


i) Approximate length and diameter of service pipe …………………………………..
ii) No. and diameter of taps ………………………………………………………………
iii) No. and details of sanitary fittings …………………….. purpose for which water is required
Domestic / Irrigation / const.

I/We hereby undertake to give the Chief Administrator due notice of any additions and or
alterations of the above ………………………. Mentioned supply which I/ We may desire to make.

Signature of Applicant

………………….. licensed plumber has agreed to carry our plumbing works of the above mentioned
premises of the applicant.

Signature of Plumber
(With licence number)
Cost of connection to be filled in by office.

…………………………….…. Ferrule complete Rs. ………………………………….. Connection


pipe ……………………….……………. 8 inches in diameter.
Laid complete ………………………..……… meter installed charges including cost of after cover
with licking arrangement Rs. …………………
Endst. No. …………………………. Dated…………………………….

Sanction …………………………………. I/d ferrule connection.

Forwarded to the Sub Divisional Engineer, [Link] Division No. ……… Sector ………,
Chandigarh for information and necessary action. It may also be checked personally that the house is
situated within the red line of village.

Recommended Recommended / Sanctioned ½ “ i/d Water Connection

S.O. S.D.E. Executive Engineer,


Incharge [Link] Division No.... M.C.P.H. Division No.2
Chandigarh Chandigarh.

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