Application form for Water/ Sewage Connection

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Tick appropriate
Name
Gender
Status of Applicant(Check where applicable)
Selected Value: 0
If applicant is not the owner,then provide details of the owner of the premises below:
Name
PREMISES USAGE
TYPE OF CONNECTION APPLIED FOR

I/We,the undersigned hereby declare that the information given on this application is true and correct,that all applicable fees and charges shall be paid and that I/We shall abide by the relevant guidelines associated with the service provided.