New Connection Application Form

1. Applicant Name  (Personal /Organizational)
2. Present Address
3. Mobile No
4. Email Address
5. NID    Passport
6. Purpose of Application	New Connection Connection Shifting Connection Enlargement
7. Purpose of Connection	Commercial Work Construction Work Household Work Industrial Work
8. Connection Size	0.75 INCH 1 INCH 2 INCH 4 INCH 6 INCH
9. Connection Location	Holding No.       Plot No.    Ward No.   01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 A1 B10 B3 B4 B5 B6 B7 B9 C1 CL1 CL2 CP1 CP2 CP3 CP4 CP5 CP6 CP7 CP8 CP9 P1 P10 P2 P3 P4 P5 P6 P7 P8 P9 S1 S2 S3 S4 S5 S6 S7 S8 S9 SB1 SB2    Area Name    Agrabad AlKaran AnderKilla Anowara & Karnaphuli B.S.G. B.S.P. BagMoniram Baized Bostami BanDel Boalkhali BoxirHat ChandanPura Chawk Bazar Chktai/Chawk Bazar Dewan Bazar Dewan Hat Enayet Bazar Feringee Bazar GhatforhadBeg Government Halishahar JamalKhan JoyNagar KabillaDham KorbaniGonj Lalkhan Bazar MadarBari PaharTali PanchLaish PatanTooly PatharGhata Patiya RahmatGonj SadarGhat Street Hydrant West Madarbari      Thana    AKBAR SHAH ANOWARA BAKOLIA BAYAZID BOSTAMI BOALKHALI CHANDGAON CHAWK BAZAR DOUBLEMOORING EPZ HALISHAHAR KARNAPHULI KHULSHI KOTWALI LALDHIGHI PAHARTALI PANCHLAISH PATENGA PATIYA PORT SADARGHAT
10. Application Date
11. File Upload	NID Copy BS Sheet CDA Plan CDA Aprv. Letter Land Document PP. Size Photo

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