Agricultural Irrigation Utility Connection Application
Applicant Information
Full Name
Contact Number
Email Address
Mailing Address
Farm Information
Farm Name
Farm Area (acres/hectares)
Farm Location Address
Ownership Status
Owned
Leased
Other
Irrigation Details
Required Irrigation Type
Drip
Sprinkler
Flood
Other
Estimated Water Requirement (liters/month)
Purpose / Crop Types
Additional Information
Other Relevant Information
Date of Application