Form Sr1/s98 - Application For Requisition Of A Public Sewer (Section 98 Water Industry Act 1991)

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325050 A-DEVSRV-SN98
Form SR1/S98
Application for Requisition of a Public Sewer
(Section 98 Water Industry Act 1991)
PART 1 – FOR ALL APPLICANTS
A. Applicant details:
Name:
______________________________________________________
Contact name:
______________________________________________
(company name if appropriate)
(if different)
Address:
_______________________________________________________________________________________________________________
____________________________________________________________
Postcode:
__________________________________________________
Contact details:
Daytime ’phone number:
_______________________________________
Mobile:
____________________________________________________
Fax no:
_____________________________________________________
Email:
_____________________________________________________
B. Site details:
Site/project name:
_______________________________________________________________________________________________________
Local authority:
_________________________________________________________________________________________________________
Site address:
____________________________________________________________________________________________________________
____________________________________________________________
Postcode:
__________________________________________________
Please indicate type of sewer required:
Foul
Surface water
Both
Please indicate type of premises:
New development
Existing
Both
Please indicate number of existing premises included in application:
________________________
Consumption (m
):
___________________
3
Number of developers applying:
_________________________________________
C. Declaration:
I agree to represent the applicants for the purposes of this request for an estimate and request that all communications be directed to me.
Signature:
_______________________________________
Full name:
___________________________________________________________
(BLOCK CAPITALS)
Date:
____________________________________________
Position:
____________________________________________________________
PART 2 – FOR NEW DEVELOPMENT ONLY
NB: Where more than one developer may wish to participate in a requisition EACH should complete a copy of this section.
All such copies should be returned with Part 1.
A. Applicant details:
Name:
______________________________________________________
Contact name:
______________________________________________
(if different)
(company name if appropriate)
Address:
_______________________________________________________________________________________________________________
____________________________________________________________
Postcode:
__________________________________________________
Contact details:
Daytime ’phone number:
_______________________________________
Mobile:
____________________________________________________
Fax no:
_____________________________________________________
Email:
_____________________________________________________

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