Panchayat:Repo18/Law Manual Page0833

         (iii)  (a) Whether the plot abuts National Highway, State Highway, District Road, or roads notified by Grama Panchayat under section 220 (b) of the Kerala Panchayat Raj Act 1994
           please put mark in the appropriate box)         :                                  yes / No 
           (b) If yes, the distance of the construction from such highway/road:............... metres 
          (iv) Minimum Setbacks/yards:
                                                                                                             Front .................................... metres 
                                                                                                             Rear :.....................................metres 
                                                                                                             Side(1) :.................................metres 
                                                                                                             Side(2) :..................................metres 
  7.   Details to be included:
           (i) Copies of proof of ownership (please put mark in the appropriate box): 
        Registered deed............................ Pattayam .......................Possession Certificate.....................................
            (ii) Consent from the owner of neighbouring plot if the construction abuts that plot boundary.
            (iii) In case, NOC/clearances as specified in rule 133 of the Kerala Panchayat Building Rules 2011 are to be obtained. a site sketch not necessarily to scale signed by the owner, showing plot boundary, outline of the existing and proposed built-up area within the plot, abutting street and width of open yards around is to be enclosed.
                                                                      DECLARATION

I............................., hereby declare that, the details mentioned above and enclosed along with are correct, complete and true to the best of my knowledge and belief and that I shall abide by the provisions contained in rule 113B of the Kerala Panchayat Building Rules 2011.

Place (Signature of the owner with name) : Date :

                                                                            APPENDIX AA
                                                                           [See Rule 5 (1), 5(2)]
                                 APPLICATION FORM FOR PERMIT FOR DEVELOPMENT/REDEVELOPMENT OF LAND

To,

        The Secretary,

................................... Panchayat

Sir,

                    I Intend to develop/redevelop the land in Survey Number .......................of ................ Village in........................

.......... Taluk..................owned by me. I forward herewith the site plan, service plan and specification in triplicate duly signed by me and by ........................................... (Name in Block letter of the registered Architect/ Building Designer/Engineer/Town Planner/ Supervisor) having Register No... ......................................together with the required documents.

                I hereby undertake to abide by the provisions of the Kerala Panchayat Building Rules, 2011 in all respect
                I request that the development/redevelopment may be approved and development permit granted to me.
                                                                                                                     
                                                                                                                                  Signature
                                                                                                                                  Name of owner: (in Block letters)
 Place:                                                                                                           Address : 
 Date:
                                                  
                                                                           APPENDIX-B
                                                                              (see rule 6(7)] 
                                                                    DEVELOPMENT PERMIT
                                                                       ...........................Panchayat 
          No :...........                                                                                                           Date : ........................
          Ref : Application dt.......................................... from Sri/Smt.............................................................