FORM A

KAJJANSI TOWN COUNCIL

THE PUBLIC OF HEALTH (BUILDINGS) RULES, 1951

APPLICATION FOR APPROVAL OF PLANS

(To be submitted in quadruplicate)

TO THE CITY ENGINEER AND SURVEYOR....................................................................……………...

I herewith submit Plans, Section Elevations, Block Plan and Details for *New Building Alterations, Additions
for use as * Domestic Building, Dwelling House, Public Building, Building of the Warehouse class, in accordance with Build-
ing Rule No. .. Plot.1663.., Block 489., Sanda, KAJJANSI Town Council, Busiro County, Wakiso District
having a frontage to...................Access….Road…………………………… ..........................................................…………
Foundations...........................Concrete.......Strip & Pad Foundation..........................................……………...
Damp-proof Course..................4 Ply Bituminous Felt Dump Proof.................................……………………………………
External Walls...........................200mm Thick Burnt clay bricks……………………………………………………………..
Internal Walls............................200mm and 150 mm Thick burnt clay bricks……………………………………………….
Mortar in Walls..............…………..Cement, Sand Mortar 1:3 mix....………………........................................................ …
Floor (describe all types of floors).... Cement Screed. in the Block........................………..
Roof (covering of).............................Clay Roofing Sheets ………………....................…………..
Ceilings..........................…….Soft boards ..................……………………………………………….
Description of Water fittings.........………….. Tyford...................................……………………………….
Means of Water supply......................................N.W & S.C................................................................………………………
Description of machinery to be installed...........Not Applicable………………………………………

Name of Architect...............……….. ……………………………………………………

Address....................................Tel. +256-……………………………………………..,
P.o Box …………... Kampala.
Cost of Proposed Works: Shs..................................215 millions ..............................................................………
I certify that the term under lease No.................................................will be fully complied with and that application
and the accompanying plans are to the best of my knowledge.
Signature of Architect.........................................................................................................................................................………...
Date............April 10, 2018..........
Full Name and Address of owner LUKYAMUZI ISMAIL
(In Block Letters)
…………………………………………P.o.Box … 75523..…K’la…..…………………
……………………………………………………UGANDA…………………………………………………………………
I hereby give an undertaking:
(a) To cleanse and maintain common parts and premises (Section II of the Public Health Building Rules, 1951)
(b) To provide dustbin bays at front of premises or in the back yard to the satisfaction of the Medical Officer of Health.
(c) To provide facilities in the back yard/on flat roof for drying of clothes to be screened to the satisfaction of the City
Engineer & Surveyor.
(d) To construct a footpath along the frontage of Building in accordance with City Engineer's requirements.

Owner's Signature __________________________________________Date ___April 10, 2018________________

N.B -Particulars of any proposed drainage must be submitted on the forms specified in the Appendix to the Drainage and
Sanitation Rules, 1950, or any rules amending or replacing the same, should accompany this application.
* Delete description inapplicable.
 T.P 1 (Revised)

KAJJANSI TOWN COUNCIL

APPLICATON FOR PERMISSION TO CARRY
OUT DEVELOPMENT OFFICIAL USE ONLY

Schedule File No.........................……….

Date Received.................…….
TOWN AND COUNTRY PLANNING ORDINANCE, 1951
TOWN AND COUNTRY PLANNING REGULATIONS, 1952

1 (i) Address or location of the proposed development.

Plot.1663.., Block 489., Sanda, , kajjansi Town
(ii) Name of Planning Area. Council, Busiro County, Wakiso District

2 Full names, postal address and telephone number

of person responsible for the development LUKYAMUZI ISMAIL
(IN BLOCK LETTERS) P.o Box …75523. K’la…Uganda…………...
3 Full names, postal address and telephone number
LUKYAMUZI ISMAIL
of person applying on behalf of the developer P.o Box …75523. K’la…Uganda…………...

4 (i) Particulars of the developer's interest (e.g.,

freeholder, lessee, prospective purchaser, Free Holder
etc.)
(ii) Details of any restrictive covenants likely to
affect the proposed development. None

5 (i) State the zone within which the proposed

development falls. Residential
(ii) Give a brief description of the proposed
development including where appropriate 5 Bedroomed Residential House with Lounge,
Kitchen & Store Room
information as to the process involved and
machinery to be installed.
(iii) State the purpose for which the land/or
buildings are now used and if used for more None
than one purpose give details.
6 (i) State whether the proposed development Not Applicable
involves the construction of a new, or the
alteration of an existing access to or from a
road.
(ii) State whether provision will be made for car Yes, To use Existing Car Parking, 3 Cars
parking within the plot and if so, for how
many cars.
(iii) Give details of the intended provision for the Hand- Loading
loading and unloading of vehicles.
7 (i) Source of water supply. N.W.& S.C
(ii) Means of subsoil drainage Public Storm Water Channels
(iii) Details of sanitary arrangements. As Per Drawings
(iv) Means of disposal of any trade refuse or N/A
trade effluents.
8 Give the area of the plot in square meters ……462.1…... m2
9. Where the proposed development includes any building or re-building operations, the following table where applicable
shall be completed.

Floor Level Use

Percentage Floor Space Plot Ratio
NOTE: Of more than one Area Covered By
use on any one floor give of plot Sq. M.
Building in SQ. m
figures for accommodation covered
allocated to each use.
Lower Ground 102.8
or Basement
Ground 114.3 …24.7 …1:4……
First 85.6
Second
Third
Fourth =
Fifth
Sixth
Seventh

Total 302.7 ……24.7….. % …1:4…..

10. Describe briefly the materials to be used, together with details of any advertising signs and any other relevant
information
likely to assist the Planning Committee in the assessment of this application.
Note: - This information should also be indicated on the plans. Burnt clay bricks, Concrete, Iron Bars

I/We hereby certify that to the best of my / our knowledge the information contained in this application is correct.

Signed...............................................

Date……April 10, 2018…

EXPLANATORY NOTES
1. "Land" "building" and "development" have the meanings assigned by the Ordinance.
2. Attendance is drawn to the Regulations, particularly Regulation 2.
3. This is for planning permission ONLY and does NOT cover any application which may be required under the
Building Rules or legislation dealing with the display of advertisements.
4. Attention is drawn to the provision of any Outline or Detailed Planning Scheme operating or in course of
preparation.
5. Attention is drawn to the advisability of agreeing the external color scheme for the development with the
committee.
6. Four copies of this schedule when completed, together with relevant attachments to be sent to:

PLANNING AND LAND Office

MANAGEMENT DEPARTMENT of
P.O. BOX origin
KAMPALA
 KAJJANSI TOWN COUNCIL
THE REPUBLIC OF HEALTH ORDINANCE
(The Drainage and Sanitation Rules 1962 (20) (I))
APPLICATION FOR APPROVAL OF DRAINAGE PLANS

I … LUKYAMUZI ISMAIL hereby make application For permission to construct the work shown on the
plan annexed hereto for drainage of the premises owned /occupied by me situated at Plot.1663.., Block
489., Sanda, KAJJANSI Town Council, Busiro County, Wakiso District and I undertake and agree to
conform in the construction of the said works with the law relating to the same.

PARTICULARS

Description of Building 5 Bedroomed Residential House with Lounge, Kitchen & Store Room .
Built of Burnt clay brick on Concrete foundation & Clay Roofing Tiles.
……………………………………………………………………
Male Female
Number of persons normally living on premises ___02____ __04___
Number of persons normally employed on premises ___01_ .01___
Whether on completion of works application will be made to connect with a public sewer
.........................…………………………………………No……………………………………………….
Proposed and existing system of drainage.... Construction of Boundary trenches................................
Proposed and existing means of disposal of soil and waste water.............................................................….
………Connection to Septic tank……………………………………………………………………..
Proposed and existing means of rain water ................................................................................................…
………………To existing Storm Water Drainage……………………………………………..
………………………………………………………………………………………………………………..
Means of disposal of manufacturing effluents (if any) ..................Not Applicable
Name and address of contractor or agent doing the work .......................................................………………
………………Not Yet Identified…………………………………………………..
……April 10, 2018……………… …………………………………………..
(Date) (Signature)

CCK/CELS 14