Professional Documents
Culture Documents
1. Name : ________________________________________________
3. HouseNo. : ________________________________________________
4. Details of Licenced
Plumber for Internai
Pipe laying
a)Name : ________________________________________________
b) Address : ________________________________________________
6. Division :
Sub-Division :
8. Other Particulars :
Date.......................... Signature
Date Signature/Seal
of Local Body
Division
Sub Division
Section
Area
1 Name of Applicant
:
2 Address for communication :
1. Building No :
2. House Name :
3. Street/Lane :
4. Posi Office :
5. Pin Code :
6. Survey No. :
7. Near House No :
Others (specify
2. Non-domestic Multipurpose
1. I hereby undertake that all the details given above āre true to the best of my knowledge and belief.
2. IherebyauthorizeM/s................................................... to execute the Plumbing work.
3. I have read/understood the relevant clauses of the Kerala Water Authority (Water Supply)
Regulation, 1991 and hereby agree to abide by the same.
1. Iherebydeclarethatlhavepersonallyinspected1hepremisestowhich1hewaterconnection
is applied for and the details given above āre correct to the best of my knowledge.
2. I hereby declare to undertake and complete the work as per the rules of the K.W. A.
3. All the inside installation will be/has been done as per the water supply rules.
4. I have personally conducted and satisfied the water tightness tēst of the sump.
II
Section Office