Panchayat:Repo18/vol1-page0831

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APPENDIX-A

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

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

APPLICATION FOR PERMIT / 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:


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