Schedule-5
(Relating to Rule 17)
Application for license or utilization of Water Resources
Date …….. ……. ……..
To,
The chairperson,
……… …….. District Water Resources Committee.
……… …….. …….. ……
Sir,
I am submitting their application stating the following particulars in order to obtain a
license for utilization of water resources in accordance with the rule 17 of the Water
Resource Regulation, 2050.
1. Full name and address of the person or doctor depurated body:-
2. Objectives:-
3. Quantity of the water resources to be utilized and purpose of utilization:-
4. Place of use of the propose water resources:-
5. Area of the place to be benefited by utilization of the water resources:-
6. Possible benefit from the proposed utilization:-
7. Number of consumer to be benefited form the proposed service:-
8. Estimated amount of money for the utilization of ether water resources send
source of money,
9. Method of utilizing the water resources;-
10. Present use and possible future use of the water resources:-
11. Other particulars:-
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The facts mentioned above are correct and true, if it is found false I am prepared to bear
according to law.
Seal of the corporate body
If applicant is corporate body
Applicant, for and on behalf of the person or corporate body:-
Full Name:-
Signature:-
Designation:-
Address:-