Panchayat:Repo18/Law Manual Page0831

                                                            APPENDIX A1
                                FORM OF APPLICATION FOR CONSTRUCTION IN PLOTS PARTS OF WHICH HAVE BEEN
                                                SURRENDERED FREE OF COST FOR ROAD DEVELOPMENT
                                                                    [See Rule 77 (1)1
                                                  (To be submitted along with the Application for permits)
                                                                ............... .............................. Panchayat 

 1.    Name of applicant (in capital letters)                                       :
 2.    Address                                                                     
                   (i) Permanent                                                

                   (ii) To which communications are to be sent                   :
 3.  Details of land surrendered under Rule 77 (1)
                  (i) Details of Town Planning Schemes as perRule 77 (1)(a)
                       (a) Name of the Town Planning Scheme 
                       (b) Name of the Road Development Project 
                       (c) Present state of implementation
                       (d) Zoning provisions of the Schemes ode :
                        (e) Other provisions of the Scheme 
              (ii) (a) Name of Scheme applicable as per Rule 77 (1)(b) 
                   (b) Implementing Agency,
                                   
                                                                                                                                                                                  Local Self Government Institution / 
                                                                                                                                                                     Development Authority / Government Dept./
                                                                                                                                                                                Quasi Govt. Organisation / Institution /
                                                                                                                                                                  registered Residents Association/Social  welfare Organizations                                                                                                                        

                                                 (please specify:............... 
                     (c) Present stage of implementation 
            (iii)  Extent of land in Sq. metres
                             (enclose sketch with all detailed measurements)
                   (a) Total 
                   (b) Required for implementation of the Scheme
                          in total from the plot 
                   (c) Surrendered free of cost for the scheme
                   (d) percentage of land surrendered
          (iv) Survey No. of surrendered land 
          (v) Name of the owner of the land so surrendered 
          (vi) Details of relinquishment
               (enclose copies of relinquishment) 
 4.   Applicability of Special Provisions
Item                              Required /Permissible as                                       Required/Permissible                                                        Remarks of the 
                                      per general provisions                                         per special provisions                                                        special commitee
Coverage F.A.R. Set backs Height Parking

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