APPLICATION FORM FOR SANCTION OF SEWERAGE CONNECTION PLOT NO/SITE NO__________________ SECTOR/PHASE ________ SIZE ___________RESIDENTIAL/COMMERCIAL/INDUSTRIAL/INSTITUTIONAL (Tick mark whichever is applicable) 1. NAME OF ALLOTTEE: 2. NAME OF GPA/SUB GPA/SPECIAL POWER OF ATTORNEY OF ALLOTTEE (if applicant is GPA/Sub GPA/SPA) 3. NAME OF FATHER/HUSBAND (of allottee) 4. PERMANENT ADDRESS (of allottee) (Telephone No.) 5. CORRESPONDENCE ADDRESS (Telephone No.) 6. DATE OF SANCTION OF BUILDING PLAN 7. WHETHER THE BUILDING IS: COMPLETELY PARTIALLY (Tick mark whichever is applicable) CONSTRUCTED DATE: SIGNATURE Name____________________ (in capital letters) The text and format of this form can be changed any time with the change in policy matters. LIST OF DOCUMENTS TO BE SUBMITTED BY THE APPLICANT i Plumber Certificate, in the prescribed form attached. ii Architect certificate regarding completion of construction, in prescribed form attached. iii Attested copy of GPA/SPA (where applicable) iv Proof of ownership (allotment/re-allotment/transfer of ownership letter) v Copy of Sanctioned plan. vi Security of Rs. 100/vii Road Out-rates (Subject to Revision) a. 30' wide road = Rs. 800/ b. 45' wide road = Rs. 1100/ c. 60' wide road = Rs. 1600/ d. 80' wide road = Rs. 2000/
