ANNEXURE-III
MORMUGAO MUNICIPAL COUNCIL
Technical Section
Application form for N.O.C for                       connection
    
    
1. Name of the applicant and address :    
    
2. Full address of the house/shop for this
No Objection Certificate is required.		 :    
    
3. Nature of purpose for which such
a connections required. (tick out)		 a) residential
    b) commercial
    c) industrial
    
4. If the connection is required for (b) and (c) above,
that is , for non-resicential purpose, give the details
of commercial/industrial activity. ( Enclose a copy of
the permission Letter/Licence issued by this Council)		 :    
    
5. Construction Licence number and date. Occupation
certificate for the house, if any. (enclose the true copy)		 :    
    
6. Municipal house number and ward No. :    
    
7. House tax : receipt number of the
house tax paid upto date		 :    
    
8. In case, the applicant is a tenant, whether the
'No Objection Certificate from the owner has been
obtained. if yes, enclose the original copy or xerox copy.		 :    
    
9. I here by declare that the above-mentioned facts presented are true to the best of my knowledge
and the respective development charges will be paid by me in the municipal treasury as required
by the municipal authority.:    
    
    
Date : Signature of the applicant
    
To,
The Chief Officer,
Mormugao Municipal Council,
Vasco-da-Gama.
 
for office use only
 
   Received Rs.                  towards the
     applicant fees vide receipt No.
  dated :
 
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