Trinidad and Tobago Fire Services Building Development Application Form

1. REF #_________________
TRINIDAD & TOBAGO FIRE SERVICE
WATER & ESSENTIAL SERVICES SECTION
PRELIMINARY WATER RETICULATION APPLICATION FORM (1A)
APPLICANT INFORMATION
Last Name Jaimungalsingh First Vedesh M.I.
Street Address House/ Apt #
City/ Town
Phone E-mail Address
National ID Number 19870403002 National ID Type
(Driver’s Permit /
Electoral ID / Passport)
Electoral ID
Are you the owner of the
proposed development?
YES NO If no, are you authorized by the owner to make this
application? YES NO
Name Of Owner (If not Applicant) RaviJaimungalsingh
Owner Contact Number 389-8489 Owner National ID # DP# 352632
PROPOSED DEVELOPMENT DETAILS
Name of Proposed Development Ponds Development
Address of Proposed Development
Municipality
(Regional Corporation)
Number of Lots or subdivisions Average Size of Lots or
subdivisions
What is the
approved usage of
this development?
For Residential Developments: Type of proposed buildings
(e.g. Single Family Units/
Multi-Family Units/
Multi Story Units etc.)
For Commercial Developments: Type of proposed
structures and usage
For Industrial Developments: Type of proposed
structures and usage
Town and Country Planning Division Approval
granted?
YES NO Type of ApprovalGranted
Town and Country Planning Division Approval
Number
Date of Approval
WASA Approvalgranted? YES NO Type of
Approval
Granted
WASA File Number Date of Approval
Are there existing residents / occupants YES NO If “Yes” state the nature of
their tenancy
WATER RETICULATION DETAILS
Size of Proposed Water Mains Type of Supply
Depth of Proposed mains Main Type
Are there existing Fire Hydrants within 100
meters of the proposed development? YES NO
If Yes, Please give number and location(s)
DISCLAIMER AND SIGNATURE
I certify that my answersare trueand complete to the best of my knowledge. I accept that if any information proves to be false or
misleading, my application will be denied.
Signature Date
Receiving Officer Date