Particulars of the person applying for the water service
ID Type :
ID Number :
ID should be scanned and attached to the form
ID File (Upload):
Particulars of the water connection service
Estimated Monthly Consumption (in litres) :
Date Connection is required :
Particulars of the water connection service location :
Premises Location :
Road :
Zone :
Area :
Plot Number :
Plot Owner's Name :
Description of the site where the connection is required (Construction site, Dwelling House, Shop, Hospital, etc):
Sketch map to the location where connection is required