General Required Information

Official

Use

Description

Applicable

Submitted

Yes

No

Yes

No

Proof of Payment of Licence Application Processing Fee (Compulsory)

Copy of Identity Document of Applicant and Proponet (if applicable)(Compulsory)

Copy of Company Registration Certificate (Compulsory)

Copy of Trust Registration Certificate (Compulsory)

Letter of Authorisation for Companies, Trusts or Legal Entities (Compulsory)

Letter of Authority or Power of Attorney to Apply on behalf of Applicant

Copy of BBBEE Certificate

Letter of Consent if the Applicant is not the Property Owner (Compulsory)

*Applicant Information Form: Individual (DW 756 / 769)

*Applicant Information Form: Water Service Provider (DW 757 / 770)

*Applicant Information Form: Company, Partnership, Government (DW 758 / 771)

*Applicant Information Form: Water User Association (DW 759 / 772)

1Property Details Form (DW 901)

Property Owner Details (DW 902)

Permission to Occupy (PTO) , Title Deed, Lease Agreement, Community Resolution

A description of the location of the activity, including

When providing coordinates, such coordinates must be provided in degrees, minutes and seconds using the Hartebeesthoek94 WGS84 coordinate system.

a plan which locates the proposed activity or activities applied for at an appropriate scale, or if it is—

Where applicable, proof of acceptance of an application for any right or permit in terms of the Mineral and Petroleum Resources Development Act, 2002 or environmental authorisation as per regulation 7 must be provided

Section 21(a) : Taking water from a water resource

Official Use

Description

Applicable

Submitted

Yes

No

Yes

No

*Taking water from a water resource Form (DW 773)

*Pump Technical Data Form (DW 784)

*Canal Technical Data Form (DW 786)

*Irrigation Field and Crop Details (DW 787)

*Supplementary Info: Power Generation, Industrial or Mining (DW 788)

*Supplementary info: Domestic, Urban, Commercial or Industrial (DW 789)

Soil Suitability Report (for irrigation from Dept. Agriculture)

Section 21(b) : Storing water

Official Use

Description

Applicable

Submitted

Yes

No

Yes

No

*Storing water form (DW 774)

*Dam and Basin Technical Data Form (DW 789)

*Dam Classification Form (DW 793) (for dams >5m and >50 000m3)

Dam Location Map

Section 21(c) & (i) Impeding & Altering

Official Use

Description

Applicable

Submitted

Yes

No

Yes

No

* Impeding or diverting the flow of water in a watercourse form (DW 763)

*Altering the bed, banks, course or characteristics of a watercourse (DW 789)

*Supplementary Information for 21 (c) & (i) form (DW775)

Section 21(e) : Engaging in a controlled activity

Official Use

Description

Applicable

Submitted

Yes

No

Yes

No

*Engaging in a controlled activity form (DW 765)

*Monitored Waste Discharge Details form (DW 904)

*Irrigation Field and Crop Details (DW 787)

Section 21(f) : Discharging waste or water containing waste into a water resource through a pipe, canal sewer or other conduit

Official Use

Applicable

Submitted

Yes

No

Yes

No

* Discharging waste or water containing waste into a water resource through a pipe, canal, sewer or other conduit form (DW 766)

*Monitored Waste Discharge Details form (DW 903)

Section 21(h) : Disposing in any manner of water which contains waste from on which has been heated in any industrial or power generation process

Official Use

Description

Applicable

Submitted

Yes

No

Yes

No

* Disposing in any manner of water which contains waste form, or which has been heated in any industrial or power generation process form (DW 780)

*Monitored Waste Discharge Details form (DW 903)

Section 21(j) : Removing, discharging or disposing of water found underground if it is necessary for the efficient continuation of an activity or for the safety of people

Official Use

Description

Applicable

Submitted

Yes

No

Yes

No

* Removing, discharging or disposing of water found underground if it is necessary for the efficient continuation of an activity or for the safety of people form (DW 780)

Section 21(k) : Using water for recreational purposes form (DW 780)

Official Use

Description

Applicable

Submitted

* Using water for recreational purposes form (DW 780)

 Application Submitted:

Incomplete

 ________________________________________

 Signature of Assessor