Water Connection Application

Service Selection

Application Type *

Number of Meters

Applicant Information

First Name *

Surname *

Phone Number *

Alternative Contact

Email Address

Postal Address

Id Type *

ID Number *

Are you also the one responsible for water charges (consumer)? Yes No

Are you the owner of the plot (landlord or land lady)? Yes No

Land Owner's Name

Information about the plot

Road

Plot Number

Area of plot (acres)

Zone *

Area *

Purpose *

Other purpose, Specify

Description of premises (Dwelling House Construction site, Hospital, School etc)

Nearest Account Number

Nearest Account Name

Main Account Number

Main Account Name

Old Account Number

Old Account Name

Information about the one responsible for water charges

First Name

Last Name

Phone Number

Alternative Contact

Email Address

Postal Address

Expectations

Date Connection is Required

Estimated Monthly Consumption (litres)

Information about the Plumbing Contractor

Name of Contractor

Contractor Primary Phone

Alternative Contact

Email Address

Uploads

Image of ID *

Sketch Map *