Application Form for Issuance of Building Development Permission in

Municipal Areas

Applicant Basic Information

1. Salutation * : ____________________________________
2. First Name *: ________________________________________
3. Middle Name: _____________________________
4. Last Name *: __________________________________
5. Mobile No. *:_______________________________
6. Phone No. : _________________________________
7. Fax No. : ________________________________
8. Email *: ________________________________
9. Status *: ____________________________________
10. Date of Application *: ________________________________

Address of Site

11. Country * : ____________________________________

12. State * : ________________________________________
13. District * : _____________________________
14. Sub-divison * : __________________________________
15. Rural or Urban * : _______________________________
16. Block/Municipality/Corporation * : _________________________________
17. Block/Municipality/Corporation Name * : ________________________________
18. Zilla Parisad * : ________________________________
19. Panchayat Samiti : ____________________________________
20. Police Station : ________________________________
21. Post Office : ________________________________
22. Address Line 1 * : ________________________________
23. Address Line 2 : ________________________________
24. Pin Code * : ________________________________
25. Holding No. : ________________________________
26. Premises No. * :________________________________
27. Mouza Name * : ________________________________
28. J.L. No. : ________________________________

Name of the Project

29. Project Name : ________________________________

Postal Address of Applicant

30. Country * : ____________________________________

31. State * : ________________________________________
32. District * : _____________________________
33. Sub-divison *: __________________________________
34. Rural or Urban * : _______________________________
35. Block/Municipality/Corporation * : _________________________________
36. Block/Municipality/Corporation Name * : ________________________________
37. Village or Ward : ________________________________
38. Police Station : ____________________________________
39. Post Office : ________________________________
40. Address Line 1 * : ________________________________
41. Address Line 2 * : ________________________________
42. Pin Code * : ________________________________

Owners Details

Salutation * First Name * Middle Name Last Name * Mobile No. Email

Country * State * District * Sub-divison * Rural or Urban *

Block/Municipality/Corpo
ration *

Village or Ward Police Station Post Office Address Line 1 Address Line 2 Pin Code *
Block/Municipality/Co * *
rporation Name *

Engaged Personnel Details

Engaged Person * Salutation * First Name * Middle Name Last Name * Mobile No. Email

Phone No. Fax Class * Registration No. * Registration Valid Till *

Address Line 1 * Address Line 2 PIN Code *

Land Details

43. Previous Classification of Land * : ____________________________________

44. Others * : ________________________________________
45. Present Classification of Land * : _____________________________
46. Others * : _____________
47. Risk * : _______________________________
48. Area of Land(m2) * : ____________________________________
49. Area of Solid Land(m2) * : ________________________________________
50. Area of water body(m2) * : _____________________________
51. RS Plot No * : _____________________________
52. On North of site like Vacant land or Road or Building with use and height or Others * : __________________________
53. On South of site like Vacant land or Road or Building with use and height or Others * : _________________________
54. On East of site like Vacant land or Road or Building with use and height or Others * : _________________________
55. On West of site like Vacant land or Road or Building with use and height or Others * : _____________________________
56. Means of access like Name of Road or Street * : _____________________________
57. Width of Road or Street including footpath ( Right of way) (m) * : _____________________________
58. Whether the plot within 500 m from the centreline or abutting * : _____________________________
59. Whether the plot area is more than 500 sq. mtr. * : _____________________________
60. Whether the proposed building height is greater than 14.50 mtr. * : _____________________________

Tenement Details

61. Tenement Size * : _____________________________

62. Tenement No * : _______________________________

Usage Details

63. Usage * : _____________________________

64. Built up area * : _____________________________________________

Building Details

No. of Buildings * No. of stores * Total volume of Height of the Inner Court yard Inner Court yard
Construction (Cubic Building * (Minimum Width) * (Minimum Area) *
M) *

Outer Court yard Outer Court yard Ventilation shaft Ventilation shaft Staircase (Minimum
(Minimum Width) * (Minimum Area) * (Minimum Width) * (Minimum Area) * Width) *
Project details

65. Maximum Height of the building (m) * : ____________________________________

66. Front Open Space (Meter) (Min) * : ________________________________________
67. Rear Open Space (Meter) (Min) * : _____________________________
68. Side Open Space (Meter) (Min) * : _____________
69. Joint Open Space (Meter) (Min) * : _______________________________
70. Ground coverage Area (Sq. Meter) * : ____________________________________
71. Ground coverage Percentage * : ________________________________________
72. Total Built up Area in All Floors (without exemption) (Sq. Meter) * : _____________________________
73. Floor area ratio (FAR) * : _____________________________
74. Organized open space Area : _______________________________________________________
75. Organized open space Minimum Width : _________________________
76. Amenities and facilities area : ________________________________________
77. Amenities and facilities ( Minimum Width ) : _____________________________
78. Total Area of covered parking including circulation : _____________________________
79. Ramp Minimum Width : _____________________________
80. Driveway Minimum Width : _____________________________
81. Required No. of Car Parking (Open) * : _____________________________
82. Required No. of Car Parking (Covered) * : _____________________________
83. Required No. of Bus Or Truck Parking (Open) * : _____________________________
84. Required No. of Bus Or Truck Parking (Covered) * : _____________________________

Other Details

85. Use Group * : _____________________________

66. List of Documents :
A. Form-C and Data Sheet Annexure * : _____________________________
B. Location Plan for the plot * : _____________
C. Site plan showing width of the abutting road (Duly sealed, signed & vetted) : _______________________________
D. Record of Rights (ROR) * : ____________________________________
E. Conversion of classification of land * : ________________________________________
F. Master plan in AutoCad file format showing obligatory open spaces(min open spaces), showing width of the abutting road and,
parking layout, location of all services, drainage discharge point (if any) * : _____________________________
G. Master plan (Scanned copy) duly signed (Applicant, Architect, Structural Engineer etc. as required) * : _________________
H. Other architectural plans/elevations/sections in AutoCad file format : _____________________________
I. NOC from Fire (W.B fire emergency services) as may be applicable : _________________________
J. NOC from SWID/Municipal corporation/Municipality : ________________________________________
K. NOC from SEAC, EIA, PCB : _____________________________
L. NOC from Irrigation &Water ways directorate : _____________________________
M. NOC from Airport Authority India : _____________________________
N. NOC from fisheries department : _____________________________
O. NOC from any other Department : _____________________________
P. Declaration from Architect registered with Council of Architecture * : _____________________________
Q. Declaration from Geo technical engineer * : _____________________________
R. Declaration from Structural engineer with structural stability certificate * : _____________________________
S. Declaration from Structura1 reviewer : _____________________________
T. Certificate of registration of Council of Architecture for Architect * : _____________________________
U. Certificate of registration of Geo technical engineer * : _____________________________
V. Certificate of registration of Structural engineer * : _____________________________
W. Certificate of registration of Structura1 reviewer : _____________________________
X. Affidavit * : _____________________________
Y. Indemnity * : _____________________________
Z. Land Ceiling Clearance : _____________________________
I. Any other Document as may be necessary : _____________________________
II. Sanctioned plan of existing building/s in case of extension/addition-alteration/revision : _____________________________
III. Signed copy of the application form * : _____________________________

I hereby declare that the above information is true to the best of my knowledge and belief.

Signature : ________________________________________________
Date of Application : ________________________________________