DELHI JAL BOARD:

Govt of NCT of Delhi

Application Form for New Connection

ARN: 256201818872

ZRO Location: Burari Application Date: 17/12/23

Type of Request: Water Connection Connection Type: Normal Connection

Details of applicant:

Name:
First Name: AARTI
Middle Name:
Last Name: DEVI
Father/Husband Name: RAM JI SHAH
Govt. Organization:
Name of Government Organization:
(along-with designation of officer whose name connection & bill is required)

Contact Details:

Email Id: AAKASHPRASAD270@GMAIL.COM Mobile No: 7210939198

Office No:

In case of DJB Employee Office Details - Please attach copy of office Identity Card

Employee Id: Date Of Retirement:

Office Name & address:

Property Address:

Address*: KH NO 6/2 HOUSE NO 1090 STREET NO- 14 Landmark: BHATTA ROAD

Locality*: SARUP NAGAR Sub locality*: NEW SARUP NAGAR
Pin Code*: 110042 Assembly: AC05
Ward: 019-N
Property and water connection use details – please refer pages - Instructions to fill the application

Property Type*: Individual House Urban/Rural: Rural

No. of Floors*: 1 No of Beds*:
Plot Area*(In Sq. m): 21 Built Up Area*(In Sq. m): 21
Water Connection Type*: Domestic Water Connection Used by*: Residential

Bank Deatils

Name of the Bank*: Name of the Branch:

Bank Account No.: IFSC Code*:

Documents to be Attached

a) Proof of Identity: *
Document Type: Unique Id Card Document No: AADHAR CARD
b) Property Ownership Document *:
Document Type: Regd GPA Document No: Property papers
C) Other Document *:
Document Type: NOC From Owner Document No:

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.
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.

Signature of Applicant*:

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,
Dharmshalas/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. Bank Details:All fields listed under bank details are compulsory and must be provided correctly.
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.
8.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 favor 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).
9.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 Banquet Hall Office Complex

Mother Dairy Booth Hotel/Guest House Dharmsalas/Hostels Apartment
Hospital/Nursing Home DDA Flats Mall/Cineplex Group Housing Society

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 YAMUNA Delhi Metro Rail Corporation Juice Shop Pvt. Schools
Banquet hall/ Party
Janta Flats Railways Delhi Transco
Hall
Beauty Parlors Delhi Transport Corporation Jewelry 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 Molding 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
North Delhi Power Ltd.
Courts Co-operative Group Housing Society Vehicle/Automobile ServiceStation
(TDDPL)
Clinic/Path lab Govt. Hospitals/ Dispensary Nickle Polish Works Warehouse/ Godown
Central Govt. Offices Govt. Institute/Collages/Universities Piao’s North MCD
Color Dye
East MCD Govt. Offices/PSU/Bank Police Department
shop/factory
ProfessionalOffice (CA,
Dhaba Haircutting Saloon South MCD
Lawyer,Property)
M.C.D. Slums & J.J.
Delhi Govt. Office Hotel &Guest houses Pvt. Hospitals &Nursing Homes
Department/DUSIB
D.S.I.I.D.C Residential Other

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
withoutNOC from Municipal Corporation

Note: Bulk Connections: -

Only bulk connection is sanctioned on a property having more than ten dwelling units. Applicationfor 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 must 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

d) Capacity & location of UGR for potable and non-potable water