v1.0_updated151014 This application form is to be submitted, together with the Project information sheets duly completed and all required documents listed in the checklist to: Mrs Ong Geok Suat, Catchment & Waterways Department Public Utilities Board #07- 01, Environment Building, 40 Scotts Road, Singapore 228231 We, _______________________________________________________________(name of organization) would like to apply for ABC Waters Certification for our project ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ __________________________ Signature of Applicant ___________________ Date _________________________ ____________________ Name & Designation Company’s Stamp Address of Applicant: For Official Use Only: Registration No. Page 1 of 10 v1.0_updated151014 SECTION I PROJECT INFORMATION (Sheet 1) Description of Project: Project Reference No. : - - - Date of DC clearance (if applicable): Date of BP submission(if applicable): Date of approval by URA(if applicable): Project Name: (Short) Type of development (e.g. School/Park/Residential / Commercial/Industrial/Mixed) Developer/Building Owner: Architect Civil / Structural Engineer Landscape Consultant Main Contractor Landscape Contractor Project Address & District Code: Expected Construction Start Date and Expected TOP Date: PROJECT INFORMATION (Sheet 2) Name and designation of DID/ Hand phone No. Email Address Contact Person# *Enclose attachment Page 2 of 10 v1.0_updated151014 # please furnish at least two (2) names SECTION II CHECKLIST OF DOCUMENTS TO BE ENCLOSED WITH APPLICATION Summary of the project Remarks/Details Site Plan* Project description (between 50 and 100 words) Facilities provided to bring people closer to water and a short description of the facilities (between 50 to 100 words) (e.g. seating spaces near to water, boardwalks next to water, etc.) Facilities:__________________________________________ Description: Facilities:__________________________________________ Description: *Enclose attachment Page 3 of 10 v1.0_updated151014 Facilities:__________________________________________ Description: Short summary of the accessibility and safety considerations plans for the above facilities and ABC Waters Design features (between 50 and 100 words) Maintenance plan for the proposed features/facilities and maintenance checklist* Description of proposed educational signage (related to ABC Waters design feature, nature, *Enclose attachment Educational Signage 1: Theme: Page 4 of 10 v1.0_updated151014 water, plants etc) or other efforts made to bring awareness to people about ABC Waters concepts and design features (between 50 and 100 words) Educational Signage 2: (attach visual if available) Theme: Description of proposal for (i) formation of interest groups or (ii) organizing sustained activities at the project site or (iii) public engagement efforts through the use of publications, social media etc. (between 50 and 100 words) Description of features incorporated to improve the aesthetics of the development (List all ABC Waters design features and other green features like green roof, vertical greenery etc.) Feature:___________________________________________ Description: Feature:___________________________________________ Description: (between 50 and 100 *Enclose attachment Page 5 of 10 v1.0_updated151014 words) Feature:___________________________________________ Description: Feature:___________________________________________ Description: List of plants within the development that are suitable for the creation of habitat (e.g. for birds, butterflies etc). Please also indicate if they are native plant species Plant Name:________________________________________ Habitat Creation:____________________________________ Plant Name:________________________________________ Habitat Creation:____________________________________ Plant Name:________________________________________ Habitat Creation:____________________________________ Plant Name:________________________________________ Habitat Creation:____________________________________ Plant Name:________________________________________ Habitat Creation:____________________________________ Plant Name:________________________________________ Habitat Creation:____________________________________ Plant Name:________________________________________ Habitat Creation:____________________________________ Plant Name:________________________________________ Habitat Creation:____________________________________ *Enclose attachment *Enclose attachment Page 6 of 10 v1.0_updated151014 Plant Name:________________________________________ Habitat Creation:____________________________________ Plant Name:________________________________________ Habitat Creation:____________________________________ Details on the ABC Waters Design Features Location Plan* Name of the proposed ABC Waters design features _________________________________________ _________________________________________ _________________________________________ _________________________________________ Cross section of the proposed design feature* Total site area of the development Total paved area of the development ___________ m2 ___________ m2 Total site area of the development that is treated by the design features ___________ m2 Total paved area of the development that is treated by the design feature ___________ m2 Total area of the proposed *Enclose attachment Page 7 of 10 v1.0_updated151014 design feature ___________ m2 Details of rain water harvesting/ treatment/ recirculation system (if applicable) (between 50 to 100 words) Confirmation if rain water harvesting (if proposed) will be integrated with the ABC Waters design features Yes No Tick accordingly Stormwater Management Plan (if applicable) (between 50 and 100 words) Additional innovative features planned for in the development/exemplary design going beyond the standard criteria of certification (e.g. creative use of drain cover design, infiltration measures, natural drainage system *Enclose attachment _________________________________________ _________________________________________ _________________________________________ _________________________________________ Page 8 of 10 v1.0_updated151014 etc) _________________________________________ Any relevant artist impression* *Enclose attachment Page 9 of 10 v1.0_updated151014 SECTION III (only applicable to projects under design / construction) DECLARATION FORM We, (name of organization) -------------------------------------------------------------------------, refer to the application for ABC Waters Certification for our project entitled: ----------------------------------------------------------------------We hereby declare that: i) We will implement the above project in accordance to the submittals for the ABC Waters Certification (application form, attached plans and information provided during clarification). ii) We will inform PUB in advance, should there be any major changes to the information submitted for ABC Waters Certification. iii) We will inform PUB upon the completion of project for joint site assessment. __________________________ __________________________ Signature of Applicant Date __________________________ __________________________ Name & Designation Company’s Stamp __________________________ __________________________ Signature of Qualified Person Date __________________________ __________________________ Name & Designation Company’s Stamp For Official Use Only: Registration No: Page 10 of 10