Panchayat:Repo18/vol1-page0833

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 per general provisions Required/Permissible as per special provisions Remarks of the special Committee

Coverage :


F.A.R :


Set backs :


Height :


Parking :


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