Panchayat:Repo18/vol1-page0831

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

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

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: