eSLA timelines: 15
DELHI JAL BOARD: Govt of NCT of Delhi days
Application Form296976261793
ARN Number: for New Connection
Photograph of the
SA Applicant
X
ZRO Location: Application Date:
1.Type of Request (Please Tick)
Water and Sewerage Connection Water Connection (Only in case where no sewerage system has been
sanjay laid by DJB) rajan
Sewerage Connection (in case water connection is not required) Regularization (in case water/sewer connection already installed without
Late RS suroop rajan
prior sanction)
2. Connection Type
tarun201@gmail.com 9911666628
Normal connection Temporary connection
3. Details of Applicant
Name: (Please Fill In Block Letters Only, in case of any organization write designation)
First Name: * Middle Name: Last Name:
Father/Husband Name*:
110074 91
Govt. Organization (Please tick if it is a Govt. Organization, provide supporting document)
CHHATARPUR ENCLAVE A-318 chatter pure enclave phase 1
Name of Government Organization:
(along-with designation of officer whose name connection & bill is required)
AC46
4. Contact Details
070-S
Email Id: Mobile No:*
near old post office
Home Tel. No: Office No:
5. In case of DJB Employee Office Details - Please attach copy of office Identity Card
Employee Id: Date Of Retirement:
Individual House Rural
Office Name & address:
1
6. Property Address
955 900
House No.:* Society/building Name:
I
Road/Street No.: Locality:*
Delhi Jal Board
Sub locality:* Village:
Pin Code:*
7. Property and water connection use details – please refer pages - Instructions to fill the application
a. Development Charges Paid (Submit Latest Payment Receipts): Water Sewerage
Water Receipt No. Sewerage Receipt No.
b. Property Type:* (Please see table 6b) c. Urban / Rur al
d. No. Of Floors:* e. No Of Room/Beds:*
x
(For Hospital/Hotels Only)
f. Area (In Sq. m):
Plot Area:* g. Built Up Area:*
280676877051
h. Water Connection Type:*(Please see table 6h)
i. Water Connection Used by:* (Please see table 6i):
(for identification/tagging purpose)
8. Details of License Plumber
a.Name of Licensed Plumber:**
b.License No.**
9. Bank Details
718
Name of the Bank:* Name of the Branch
Bank Account No. IFSC Code:*
Canaran zamrudpur commercial complex m46 greater kaliash part 2
CNRB0005282 2741103001316
X
10.Documents to be attached
a) Proof of Identity: * □ Driving License □ Passport □ Ration Card □ Aadhaar Card
(any one) □ PAN Card □ Voter Identity Card □ Bank Pass Book with applicant’s Photo
□ Photo Identity card issued by any govt. agency
Document No: * Ownership Status:
b) Property Ownership Document (any one) *:
□ Registered conveyance Deed / General Power Attorney □ Registered Sale Deed
□ Notarized General Power Attorney with complete chain □ Registered perpetual lease Deed
□ Will/No Objection Certificate of the owner in favor of applicant □ Registered Relinquished deed
□ Registered Partition deed/Family settlement deed □ Special Power Attorney with
□ Allotment letter (Private Builder) with registered sale □ Registered/Notarized Agreement to sell and will
deed / General Power of Attorney □ Electricity Bill in the name of an Applicant
□ DDA allotment/mutation letter/Land & Development Office Letter
□ Rented property-lease/Rent Agreement, No Objection Certificate of Owner □ Interim court order, if any
Document No. / Document registration no.*
11.Declaration/Undertaking
DECLARATION:
a) I hereby declare that all the information furnished by me is true to the best of my knowledge and if any discrepancies
are found, I will be responsible for disconnection of services by the DJB without any prior notice and any other legal action
taken by DJB.
b) I declare that there is no dispute on property and there is no stay from any court of law against obtaining water/
sewerage connection.
c)I understand that sanction of connection does not acknowledge or confer any title, ownership or occupancy right in favor
of the applicant.
Signature of Applicant: *
UNDERTAKING:
i) I further undertake that in case of any dispute about the ownership of the property I will absolve DJB from any legal
battle in the court of law as the water connection applied for is related to supply of potable water and not to decide the
ownership of property.
ii) I further undertake to pay the charges as and when demanded by DJB, and in the event of non-payment, DJB will be at
liberty to disconnect the services being provided by DJB.
iii) I further undertake that I have not taken “DJB Employee Rebate” against any other Premise/Connection.
iv) I undertake to install my water connection only through license plumber of Board.
v) I undertake that water/sewer connection will be laid without damage of the distribution line and wherever required,
connection from the loop line will be taken.
vi) In case of variation in plot size as per document submitted by the undersigned and on actual measurement by DJB
representative, difference of Development charge/any other charge on actual measurement will be paid by me.
vii) In case connection is found non-feasible on technical ground as per any prevalent policy of DJB the water connection
may be denied or if sanctioned inadvertently, the said sanction may be withdrawn and may be disconnected without any
notice.
viii) I hereby undertake that all the facts and documents submitted are true and correct, in case of any misrepresentation
or wrong facts etc., sanction of connection may be disconnected without any notice.
□ I Agree Signature of Applicant: *
Note: All columns in the form marked * are mandatory and the Service area of ZRO Location may be searched on-line under “Contact
us” link or applicant may confirm it from nearest neighbor or contact nearest ZRO office
Instructions to fill the Application
1. Type of Request : Select the type of connection request.
2. Details of Applicant:
Please tick if it is a Govt. Organization and provide supporting document with the
application form. All details must be provided in Block Letters except Email ID.
First Name and Last Name: Should be provided. First Name is compulsory.
Father/Husband Name: Applicant's father or husband name should be provided and is
compulsory. Strike through the one that is not applicable.
Example:
Father/Husband Name: MR. SUMIT KUMAR DUTTA (If father's name is provided and vice versa.)
UID number may be provided but is not compulsory.
3. Contact Details:
Email Id: Should be provided in exact case. It is optional.
Mobile No: It is compulsory to provide mobile no., as it will be used for sending SMS alerts.
Home Tel. No: May be provided to facilitate communication. It is optional.
Office No: May be provided to facilitate communication. It is optional.
4. Office Details:
Employee ID: The employee ID of the applicant. To be provided by DJB employees only.
Date of Retirement: The date of Retirement of the Applicant. To be provided by DJB employees only.
Office Name, Address with, Pin Code may be provided to facilitate communication
5. Property Address:
Pin Code: Pin code of the property must be provided. It is compulsory.
Locality, Sub locality and House No must be provided correctly. These are compulsory.
Road No, Sub locality 1, Sub locality 2, Sub colony, Village, Khasra No, Society Name, JJR colony should be provided.
These are optional.
6. Property Details:
a. Development charges Paid: If development charges are paid for either water or sewerage or both, the photocopy of the
related receipt must be attached with the application form.
b. Property Type: This may be Tower, Office complex, Mother dairy Booth, Mall/Cineplex, Individual house, Hotel/guest House,
Hospital
/Nursing home(No. of beds must be provided In this case), Group Housing Society, Govt Flats, Dharmashalas/Hostels, DDA
flats, Bungalows, Banquet Hall, Apartment. Any other property type will not be accepted. It is compulsory. Refer to the table
Property Type below.
c. Urban: Please tick it if the property is present in an urban area.
d. No. of floors: Must be provided. It is compulsory.
e. No. of beds: Must be provided in case the property type is Hospital/Nursing home.
f. Plot Area: Enter the total plot area. It is compulsory.
g. Built Up Area: It is compulsory to provide the built up area. It must be less than or equal to plot area.
h. Water Connection Type: It is compulsory to provide the Water Connection appropriate category (I & II) as mentioned
in the table Water Connection Type below on next page.
i. Water Connection Use: It is compulsory to provide the connection use. (Example: Delhi Fire Service, Group Housing Society
etc.).
Refer to the table Water Connection Use below on next page.
7. Details of License Plumber:
Applicant has to lay & install water connection from DJB service line through appropriate sanctioned ferrule only through
License Plumber approved by the Board. Therefore, applicant may engage any License Plumber out of the list available in ZRO
office/DJB website and details if such plumber is mandatory to be filled in column 7 of the form.
8. Bank Details
Name of the bank: Enter the name of the bank.
Name of the branch: Enter the name of the branch of the bank.
IFSC code: Enter its IFSC code of the Bank.
Bank Account Number: Enter the applicants bank account number.
All fields listed under bank details are compulsory and must be provided correctly.
9. Documents to be attached:-
Proof of Identity : Attach photocopy of any one of the following documents and provide the document number.(Voter ID card,
Ration card, Passport, PAN card, Driving license, Unique Id Card[UID/Aadhaar Card],Bank Pass Book with applicants, Photo
identity card issued by any Government Agency).
Property Ownership Document: Attach photocopy of any one of the following documents and provide the document number.
(Registered Sale Deed, Registered perpetual lease Deed, Registered conveyance
Deed, General Power Attorney, Notarized General Power Attorney with complete backchain, Special Power Attorney with
Registered/Notarized Agreement to sell and will, Will/Non Objection Certificate of the owner in favour of applicant , Registered
Partition deed/Family Settlement Deed, Registered Relinquished Deed, Allotment Letter (Private Builder) with Registered Sale
Deed, Allotment Letter (Private Builder) with Registered/Notarized. General Power Attorney ,Allotment Letter (Private Builder),
Registered/Notarized , Agreement to sell, Rented property- lease/Rent Agreement, Non Objection Certificate, Ownership, DDA
allotment /mutation letter/Land, Development Letter, Interim court order ).
12.Declaration:
I agree:Tick the I Agree check box to accept the declaration.
Signature of the applicant: Put in the signature of the applicant in the box given.
This form captures some information (say Billing Address etc.), which may be used by DJB in future.
Reference 6b : Property Type (Enter any of the below in Property Type )
Tower Individual House Govt Flats Banquet Hall
Office Complex Hotel/Guest House Dharmasalas/Hostels Apartment
Mother Dairy Booth Hospital/Nursing Home DDA Flats
Mall/Cineplex Group Housing Society Bungalows
Reference 6h: Water Connection Type (Enter any of the below in Water Connection Type)
I Domestic
II Commercial/Industrial – Please see Important Instructions & Conditions below *
Reference 6i : Water Connection Use (Enter any of the below in Water Connection Use)
B.S.E.S. RAJDHANI Delhi Jal Board Ice-Cream Factory/Ice Factory Pvt. Institute/Colleges/
Universities
B.S.E.S. YAMUNA Delhi Metro Rail Corporation Juice Shop Pvt. Schools
Banquet hall/ Party hall Delhi Transco Janta Flats Railways
Beauty Parlors Delhi Transport Corporation Jewelery Manufacturing Factory/ Repairing Religious Place
Blind Schools Dhobi Ghats Lab/ X-Ray Units Restaurant
Bottling Plant Delhi Development Authority Mutton Shop Soft Drink Factory
C.P.W.D. Dry Cleaners Moulding Machine Factory Sweet Shop
Cineplex Factory M.T.N.L Shops
Cold Storage Delhi Fire Service (Fire Station) Malls Soda Water Factory
Cooling Plant Fruit & Vegetables Store- Reliance Safal Milk Dairy Tea Stall
Courts Co-operative Group Housing Society North Delhi Power Ltd. (TDDPL) Vehicle/Automobile Service
Station
Clinic/Pathlab Govt. Hospitals/ Dispensary Nickle Polish Works Ware House/Godown
Central Govt. Offices Govt. Institute/Collages/ Universities Piaos North MCD
Colour Dye shop/factory Govt. Offices/PSU/Bank Police Department
East MCD
Dhaba Haircutting Saloon Professional Office(CA, Lawyer, Property) South MCD
Delhi Govt. Office Hotel & Guest houses Pvt. Hospitals & Nursing Homes M.C.D. Slums & J.J.
Department/DUSIB
D.S.I.I.D.C Residential Others
Important Instructions & Conditions for Commercial/ Industrial Connections (*)–
1. DJB shall not grant any water/ sewer connection to industries/ units without having consent to establish
under the Air & Water Acts from the Delhi Pollution Control Committee
2. DJB shall not sanction Commercial/ Industrial connection in residential/ non-conforming area without
NOC from Municipal Corporation.
Note: Bulk Connections:-
Only bulk connection is sanctioned on a property having more than ten dwelling units. Application
for Bulk connections will require following additional documents:
a) Electronic Drawing of layout plan, key plan, all floor plan with area details in Auto-CAD or any other electronic
form.
b) Details of internal network marked on maps in cases where system has to be taken over by DJB.
c) Scanned copy in PDF of hydraulic calculations and water demand.
d) Capacity & location of UGR for potable and non-potable water.
e) Provision of Roof Top Rain Water Harvesting, waste water recycling etc.
