FORM - A APPLICATION FOR SUPPLY OF WATER To The Municipal Commissioner, ------------------------ Municipality. Sir, I -------------------------------------------------- the Owner/Occupier of the under noted building hereby request that you will arrange to supply me with water for domestic/non-domestic purposes in house No.-------------------------Street. The Domestic/non-domestic purpose referred to is for ---------------------------------- and the quantity of water likely to be consumed for such purpose is -----------------------------------------------------litres per day for water taken for domestic/non-domestic purpose, I agree to pay charges at the rates specified in this bylaws. I further undertake to pay the meter rent and for maintenance charges as fixed in the bylaws. In the event of my desiring to terminate the contract for the supply of water herein provided for I undertake to give a month's notice in writing to the Executive Authority to that effect. Signature of the Owner/ Occupier of the premises. Dated: Address: ----------------------------Municipality Estimate For Pro. Repair/Laying to pipes in House No....................... Street Qty. Description of Materials Rate of ½ or ¾ Amount Remarks pipe materials as per to per Rs. P. Rs. P. Materials to be supplied by the Party: G.I.Pipe M G.I.Bend Each G.I.Coupling G.I.Reducers G.I.Elbow G.I.Union Union Washer 1.Nails Surfaces box(c1)6x6x4 Screw down tap ¾ Stop cock Non-Return Valve Screw down ferrule adjectable G.I.Cover ferrule G.I.Tee/G.I.Nipple Saddle place for drain G.I.Cover pipe for drain M MISCELLANEOUS Each Water Meter Checknut Testing charges Meter fixing charges Labour for work done by the plumber Picking & Removal of B.T. Surface Sq.m. Cutting Cement concrete Surface Truo to axis Each work excavation & refilling (E w to b done atleast for 1'6 Cu.m. debth & 1' & 3' Width) Labour charges for boring in main Inclusive or charges for tools taping & Each Threading if done by the plumber Laying conveying G.I. Pipe to frenco Within a farion conveying & Laying to M Proper ground alignment with Specialist including jointing. Cutting & threading G.I. Pipe Painting G.I. Pipe with Red-Oxide Joint Painting one coat. Boarding holes in Walls using Jumper & Covering the same with the cement motor 1:4 Walls 0'9' ''1' - 13/4" Each "1 - 6" Constution of Mancnery for pits for stop cock Including fixing surface box, diameter Conveyance of Materials and tools above one Furlong within municipal limit Fixing 'L' Neil in Walls Estimating charges with plan & estimates Each LS DEPARTMENTAL CHARGES Reformation WBM, Road 4' thick Now metal 1½ thick old metal Sq.m. Reformation B.T. Surface damaged Including WBM Reformation of Cement concrete Slabs only 1:2:4 Damage to Municipal Mains Supervision charge 15% on the Total Cost of Materials Each Labour and Departmental Charges TOTAL Rs Signature of the House Owner Licenced Plumber Junior Engineer Municipal Engineer -------- Municipality -------- Municipality ----------- Municipality MUNICIPALITY WATER WORK DEPARTMENT PLAN SHOWING THE PROPOSED SERVICE CONNECTION Door No. .................. Street Existing ................... Main Proposed ................... G.I..Pipe Line Approved in No ........Date..... Municipal Licenced plumber..........Municipality. Junior engineer Municipal Engineer .......Municipality ......Municipality FORM B Application for a new house-connection or for transferring, Metering, extensions, alternations and repairs to an existing house connections ( under section 306 (7) (b) of the Tamil Nadu District Municipality Act. ) To, Date The Commissioner, .......Municipality. Sir, I beg to give you notice that I Intend to effect (1) a new water supply house service connection or (2) Transferring metering extensions, alternations and repairs to the existing connection in house No. In Street Ward and in accordance with the Under Section 306 (7) (b) by-law framed I forward herewith Estimate in duplicate I have the work to be done and its cost Engaged of the said work Rs......licensed plumber For carrying out I request that permission be accorded for executing the said work. Signature of the Owner Address COMPLETION CERTIFICATE 1. Work commenced on . 2. Work completed on . 3. Deviation if any . 4. Amount to be recovered if any on actuals . 5. Amount to be refunded if any on actuals . Certified that the work has been completed as an estimates and land approved (with deviations as stated above) and hence balance of Rs....... (in words).................... may be recovered from the party, refunded to the party Ar completion report. Overseer/Junior Engineer...............................Municipal Engineer ..................................... Amount of Rs..................... in Words...................... Recovered in Challan No...................................... Dated ................Refunded in refund Voucher No.................................................... Dated ........Entered in sewage connection Register Aege .......Item No.............................. RECORDED Municipal Engineer Municipal Commissioner --------------------------------------------Municipality Under Ground Drainage Estimate Form for Providing New House Service Connection /. Alternation Repairs Name of Applicant: No: Door No. or T.S. No. Street Nos. Rate Per Amount Rs. Ps. PART A 1. Form main Sewer to Syphone Pointin the Street ( Rft) PART B From syphone point to water closet and drain in lot point inside the house (Materials supplied by the party) S W G Pipes 4" or 6" size S W G 'Y' or T junction pipes 4 or 6 Stone ware gully pipes 4 or 8 Indian water closet with 'P' traps Foot rests Absestos cement pipe 4" sie for providing as vent A C Wire Gowl C I Manhole covers 13"X18" or 4"X24" SWG Bonds 4' OR 8" C 1 'I' or 'Y' Pipes 4 or 6 C 1 'I' or 'Y' Pipes 4" or 6" PART C Labour Charges (Done by plumber) Earth work excavation including refilling Laying and joining SWG Pipes 4" or 6" size as specifications Fixing A C Vont pipes Fixing the water closet as per specification Dismantling the flooring cone Boring holes in the walls Fixing the gully trap 4" or 8" size Construction of manhole chambers of 13 x 18 or 24 x 34 size as instructed by the authority Fixing CI Pipes 4" or 6" size TOTAL ESTIMATE NO PART - D Total cost of Estimate --------------------------- } Rs 1 Centage and Supervision charges at 15% } of the total cost of the estimate subjected to } Minimum of Rs.15/- (ie) 15/- of Parts A+B+C Labour charges Inclusive of Materials for the Work of street house service connection from main sewer to syphone Point Rs. Amounts to be remitted to the Municipality by the party Signature of the Applicant. Checked and found correct Signature of the Plumber Drainage Work Supervision SKETCH Inspected, The estimate may be approved and a sum of Rs. -----------(in words)--------------------------------------- may be permitted to be remitted to the party in Municipal Treasury as per this Estimate. Drainage Work Supervisor SANCTIONED Municipal Engineer Municipal Commissioner. ---------------------------------------------Municipality FORM - C From Dated To The Municipal Commissioner, -------------------------Municipality, Sir, I wish to give notice that I intend to effect (1) a new drainage house service or (2) extensions, alternation and repairs to the existing connection in House No.--------- in -------------------------- Street Ward and in accordance with the Bye-laws framed under section 306 (7) (b) of the Tamil Nadu District Municipalities Act 1920 as amended I forward here with an estimate and plans induplicate of the work to be done I have engage Thiru --------------------------------------------------- a licensed plumber works for carrying out the said work., I request that permission may be accorded for executing the said work. Signature of the owner or occupier Address ----------------------------------------------------------------------------------Signature of the licensed plumber Address ------------------------------------------------------------------------------------Estimate No: ----------------------------- COMPLETION CERTIFICATE Work commenced on Work completed on:. Deviation if any. Amount to be recovered if any on actuals .. Amount to be refunded if any on actuals .. Certified that the work has been completed as per estimates and plans approved (with definitions as stated above) and hence Balance of Rs. ---------------(in words -----------------------------------------------------may be recovered from the party/reunded to the party as per completion report. Overseer/Junior Engineer. Municipal Engineer.-------------------------------------------------------------------------------------Amount of Rs. -----------------(in words---------------------------------------------------------------------- Recovered in Chalan No.---------------------------Dated Refunded in refund Voucher No.----------------------- Dated---------------------- Entered in sewage connection Register Page Item No.--------------------------------------------- RECORDED Municipal Engineer Municipal Commissioner.
