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 :
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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