GOVERNMENT OF PONDICHERRY PUBLIC WORKS DEPARTMENT PUBLIC HEALTH DIVISION - I WATER WORKS SUB-DIVISION, PONDICHERRY APPLICATION FOR WATER CONNECTION (To be filled in by applicant) Policy No. Name of applicant (in capital letters : Address to which connection required : Present or permanent address : Purpose : New connection - Domestic/Commercial Name of P.W.D. Pipe contractor : Address : Date: Signature of applicant. OFFICE USE Serial.No...........AE/WW/..........dated......200.... Government/Private meterNo.......Make and Diameter............ Date of connection ................................. Road cutting permission ................................ UNDERTAKING I,........................................... Street...............................Pondicherry the owner of the house agree to disconnect the supply, if any dispute arise on the property or violation of any water works rules, regulation and other Government orders issued from time to time. Signature of applicant GOVERNMENT OF PONDICHERRY PUBLIC WORKS DEPARTMENT WATER WORKS GOVERNMENT OF PONDICHERRY PUBLIC WORKS DEPARTMENT WATER WORKS Water connection Policy Thiru................. Street ................. No................... Policy No. Date of commencement......... Date of termination............ Previous Policy holder Policy No................ Thiru................. Quarterly payment of water charges Maintenance Of the meter........ Rent Advance Water charge advance........... Removal of the meter.......... Refund on............... Remarks Water connection are governmed by- 1. The ar te of............. Called the rules of the Water Works Department, Pondicherry. 2. The ar te of............. 3. This Policy. In default of prior notice this policy shall be renewable from 3 to 3 months by Tacit agreement. Stamp charges for this policy and other charges shall be borne by the consumer. I,............residing at ....................Street, hereby apply to the Water Works Department, for water connection in premises at No..... ....Street ........ of which I am the owner/tenant and for the purpose I have elected domicile with assignment of juridiction in the locality covered by this policy. Water will pass through a meter, and I undertake to pay water charges for previous quarter within such time-limit as will be fixed for the said payment. The meter has a diameter of ....... Govt . / Pvt.............. It is my property and I undertake to pay every 3 months along with water charges a sum of Rs....... being the charges for the maintenance of the meter by the water Works Department. It is the property of the Government which it is placed at my disposal and maintenance against payment of a rent of...............meter reading will be taken every 3 months. Further, declare that I have thoroughly gone through the ar te of....... framing rules for the Water Works Department, Pondicherry and under take to abide by all the clauses and conditions, made in duplicate in Pondicherry on.......... (Affix the stamp here)
