Appendix M — Application Format for Permit to Construct Water Supply and Distribution System

Application for Permit to Construct Water Supply and Distribution System

1. Name of the Applicant (Owner of holdings):__________________________________

Father's Name: ________________________________________________________
Mother's Name: ________________________________________________________

2. Address & Location of Plot/Holdings:

Ward No.________________ Road No.______________ House No.______________

Boundary Description___________________________________________________

3. (a) Description of Holdings, Buildings and Premises (Type of Building/Structure)____

(b) Occupancy Classification______________________________________________
(c) No. of Floors, Room Nos.______________________________________________

4. (a) Total Population____________________________________________________

(b) Type of Connection (Residential_______/ Commercial______/Industrial________
(c) Total Water Requirement (Calculation Sheet should be attached)___________and

   (d) Size of Water Connection (diameter of pipe) required______________________
5. Under-ground water Reservoir Capacity (where required)___________________
6. Certificate of Bill Payers _________________________________________________
7. This application is accompanied by all required plans, drawing of buildings, design
   calculations of water requirement in accordance with Section 5.3.2 and 5.3.3 of
   Bangladesh National Building Code.
___________________________                             _________________________

Signature of the licensed plumber                       Signature of the Owner or his/
                                                        her designated person/agent
Name and Address _________________         Name and Address____________________
________________________________           ___________________________________

________________________________           ___________________________________
 ________________________________           ___________________________________