Application form for Bio gas connection 1. Name in Full :_______________________________. 2. Full Address :_________________________________________________________ 3. Name of Land Lord if applicant is tenant :________________________________ 4. Purpose for which will be used (Strike off which-ever is no applicable (a) Domestic (b) Industrial/Commercial). (c) Laboratory. 5. No. of gas point required a_____________________________at_____________________________floor. 6. If tenant give no objection certificate duly attested by area councillor/any Competent Authority. SIGNATURE OF LAND LORD 7. I agree to abide by the rules and regulations of gas supply as may be formulated by Jammu Municipal Corporation (JMC) from time to time. 8. I will not hold Jammu Municipal Corporation responsible for the as connection is delayed due to technical reasons for some other damages from the Jammu Municipal Corporation except the connection fee paid by me. 9. If the gas connection delayed or if due to reasons as per para-7 above the gas connection is not possible, I will not claim any other damage from the Jammu Municipal Corporation except the connection fee paid by me. 10. The following documents be submitted at the time of submission of an application for gas connection. (a) Copy of Ration Card with original. (b) Ownership of property (Register please deed/Sale deed/Latest House tax.) (c) Tenancy (Rent agreement/Rent deed/Rent receipt) No objection certification from Land Lord duly attested by area Councilor or any Competent Authority. 11. In case of any dispute the Commissioner ,JMC will be the arbitrator and the decision given by him will be final and binding. Ration Card no ______________________ Total Family Members_______________________ Details of Family Members as under:- S. No. Name. Relation with Head of the Family Age 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. SIGNATURE OF APPLICANT For official use only. Report of JE's/AE's (E&M) 1. Purpose for which gas connection is applied for domestic/commercial. 2. Size of ferrule/main line. 3. No. of gas connection already existing at ____________________ 4. Gas connection required at ______________ floor of the Hour/Flats 5. Wheather Bio-gas street main exist near the residence: ___________ 6. Wheather area approved for sewage gas connection. ____________ ASSISTANT ENGINEER (E&M) JR. ENGINEER (E&M) Amount of Security ________________ Receipt No. _____________________ Dt. ______________ Amount of Estimate _______________ Receipt No. ___________________ Dt.__________________ DEALING ASSTT.
