Panchayat:Repo18/vol1-page0831

APPENDIX-A</big

[See 7(1) and 134 (1)]

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

APPLICATIONFORPERMIT/REGULARISATION

1. Name in Capital letters:

2. Address- (i) Permanent: (ii) To Which Communication are to be sent P:

3. Nature of development/construction- (i) Division of plot: (ii) New construction: (iii) Reconstruction: (iv) Alteration: (v) Addition/Extension: (vi) Digging of well: (vi.a) Hut: (vi.b) Compound wall: (vii) Change in occupancy: (viii) Erection of Telecommunication tower /other structure: (ix) Demolition:

4. Details of plot- (i) Survey Number: (ii) Extent: iii) Nature of ownership: (iv) Number and date of deed / document; (v) Registrar's Office: (vi) Sub Division; (vii) Ward Number: (viii) No. of the nearest building: (ix) Revenue Village: (x) Taluk; (xi) District ;

5. Occupancy- (i) Residential Group A1 : ........................................ (State the number of dwelling units also) (ii) Non residential/Others (Please specify) ........................................

6. Whether Government or Quasi Government:

7. (i) Plinth area of the proposed building: (ii) Details:

FIoor Area in sq.metres

Plinth Area | Carpet Area

Basement/Cellar floor:

Ground floor :

First floor:

- - - - - -

..................

Total Area:

ഈ താൾ 2018 -ലെ പഞ്ചായത്ത് റെപ്പോ നിർമ്മാണം യജ്ഞത്തിന്റെ ഭാഗമായി സൃഷ്ടിച്ചതാണ്.