Panchayat:Repo18/vol1-page0833

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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)]

(To b 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 per rule 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 Scheme :
:(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 Organisation
:(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                                            as per special provisions                                           special Committee 
Coverage:
F.A.R :
Set backs :
Height :
Parking;