FORM SSA/PDC/6

SEWERAGE SERVICES ACT 1993 SEWERAGE SYSTEMS AND SEPTIC TANKS NOTICE OF COMMENCEMENT OR RESUMPTION OF SEWERAGE WORKS
Date: To: The Director General of Sewerage Services I/We hereby give notice that after the expiration of 4 days from the receipt of this notice we intend to commence/res me the constr ction of the wor!s hereinafter described and to be constr cted at: "#T $%&''( )*+I) SITI,W,-( D,./,0 ),-1*-G 2./,+ D,/*" /ID3*,-4 *nder my/o r s pervision on the 5555 days of Description of wor!:6 7,D,-G,- ).)8I-, D,- ).-9I,2+,- S.8*,0 +.D,I in accordance with ,pproval 2lan -o: -ame:in bloc! letters;: I474 -o: ,ddress:

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5555555555555555555555555555 Signat re of = alified 2erson :7ivil .ngineer;

I hereby certify that all written information provided by me in this chec!list is f ll( complete( tr e and correct and are in accordance to the >G idelines for Developer?( the )S%@@& >7ode of 2ractice for Design and Installation of Sewerage System( and other reg latory agencies reA irement4 -ame :in bloc! letters;: I474 -o4: ,ddress: Telephone -o4: <ax -o4: Sewerage 7ontractor:s; "icence -o: 7lass: Balidity 2eriod:

5555555555555555555555555555 Signat re of "icensed 7ontractor:s;

FOR OFFICE USE ONLY Date received: /eference -o: 5555555555555555555555555 5555555555555555555555555