市民要求渠务署进行渠务接驳申请表-dsd.gov.hk.docVIP

APPLICATION FOR DRAINAGE CONNECTIONS 接駁雨水或污水渠申請表 Date 日期 .............................................................. To : Chief Engineer Division, Drainage Services Department 致： 渠務署 .................................................................................. 部總工程師 I, the undersigned request that you cause the works specified in the schedule (“the works”) below to be carried out in connection with the following premises : 本人(下署名者)請你進行下表中與下述樓宇有關的工程(簡稱「工程」)： Lot No. 地段編號 Address 地 址 I agree to pay to The Government of the Hong Kong Special Administrative Region (“The Government”) the cost of the works involved including all costs, fees required to be paid by reason of any enactment or regulation or bye-law in relation to or for the execution of the works and including prescribed fees and economic costs referred to in Schedule 3 of the Land (Miscellaneous Provisions) Regulations, Cap 28A for an extension in respect of an excavation permit made under the Land (Miscellaneous Provisions) Ordinance for the execution of the works, labour, materials and departmental overhead charges within 14 days of the presentation of a Demand Note to be rendered by you. 本人同意在接獲由你所發出的繳費通知書後14日內，向香港特別行政區政府(以下簡稱「政府」)支付所涉及工程的開支，包括所有與進行工程有關或進行工程所需的一切開支、、 I also agree that the Government may cause the works to be carried out and completed at such time or times as the Government may at its sole discretion determine and that the Government shall not in any circumstances be held liable for any delay howsoever arising in carrying out and completing the works. 本人亦同意政府可自行決定該工程在何時進行及完成，並且在任何情況下政府可毋須就在展開或完成工程中所引致的阻延負上法律責任。 Schedule of the Works Required 所需進行的工程 Details of Works, such as no., size and length of the connections 工程資料諸如接駁渠管數目、 口徑大小及長度 Approx. date Required 大約需要的完工日期 Approx. date when a clear and safe site will be ready for commencement of the works 可以提供已清理及安全的地盤以便開始施工的大概日期 (a) F