Vijayawada Municipal Corporation

TOWN PLANNING SECTION

BUILDING APPLICATION FORM

BA No.: 1073/1103/B/VMC/OLDRRPT/2024 Date of submission : 29 July, 2024

Sub: Building Application for grant of permission for Construction of Building Permission Notice u/s 209 & 227 of APM
Act, 1965 / 428 & 433 of HMC Act, 1955.

A ADDRESS OF THE APPLICANT

1 Name (In Full) SK NIZAMUD AHMED S/O SK KHUTUBUDDIN
2 Firm Name -
3 Door No./Flat No. 19-14/1-3/1, VIJAYAWADA MUNICIPAL CORPORATION, Revenue Ward 49, Vijayawada
4 Road/Street OLD MASJID STREET
5 Locality / Mandal NA
6 City VIJAYAWADA PIN 5 2 0 0 0 1
7 District NTR
8 Phone / Mobile No. 9948565764
9 E-mail [email protected]

B LOCATION OF THE PROPOSED SITE

1 Ward No. Block No. Ward 14 BLOCK 6
2 Layout Location BLOCK 6
3 LRS No. NA
4 RS / TS No. 2/1-RESI
5 Plot No. NA
6 Premises No./Door No. 19-14/1-3/1
7 Road/Street Old Masjid Road
8 Locality Old Rajarajeswari Peta
9 City/ Town District Vijayawada NTR

C DETAILS OF BUILDER / LICENSED PERSONNEL

# Name Address License No. Validity

1 Syed Khadar babu (Engineer) 8-2B-4, 2nd floor, Abothula vari CE-11/19 03 April, 2025
street, Wynchipet, vijayawada
2 - - - -

D DETAILS OF PROPOSED CONSTRUCTION

Site Area (sq. mtr.) As per Documents 83.61
1
As on Ground 83.22
2 Total Floor Area (sq. mtr.) 69.6
3 Tot-lot Area (sq. mtr.) 00.00
4 No. Of Units 2

E DETAILS OF BUILDING
1 No. of Blocks 1 Total Built-up Area (sq. mtr.) 34.80
 Height
# Building Name Use Sub Use Type No. of Floors Bifurcation of Floors
(mtr.)
1. A (B) Residential Individual NA 6 Floor BUA
Residential Floor Name
(sq. mtr.)
Building
GROUND 34.8
FLOOR
FIRST 34.8
FLOOR
F AUTOCAD FILE
1 AutoCAD File nizam predcr.dwg

G APPLICATION CHECKLIST
# Description Yes/No Remarks
1. Is CLU is applicable? No -
2. Whether proposed site has VLT/Assessment number? No -
3. Whether proposed construction is an Educational building? No -
4. Whether The Proposed Building Is Already Constructed Without No -
Approval But Satisfying Present Rules
5. Whether the building is pre-certified from IGBC (Indian Green No -
Building Council) or LEED India or TERI or GRIHA following the G.
O. Ms. No. 30 Dated: 28.01.2014 to avail incentives under rule 145.
6. Whether the proposal falls in Urbanisable Land use zone? No -
7. Whether ECBC is complied for commercial buildings or other No -
Non-Residential Buildings proposals having plot area more than
1000 Square Meters or built up area of 2000 Square Meters or if the
building is a Multiplexes, Hospitals, Hotels, and Convention Center
with irrespective of built up area.?
8. Do you want to apply NOC from NMA?. No -
9. Whether NMA NOC is available with you for proposed construction No -
sites?.
10. Do you want to apply NOC from AAI? No -
11. If you are in Airport vicinity, Do you have NOC from AAI? No -
12. Whether any Approved Plan given in proposed site? Yes -
13. Whether site falls under Approved Layout/LRS/Plot part of LRS No -
Layout but not regularized ?
14. Whether 10% of EWS/LIG on the project site or 25% of total No -
number of units provided within a radius of less than 10km from the
project site in Group Housing/Development projects?
15. Whether Environmental Clearance is required for proposed No -
bulding?
16. Whether the Land is converted Agriculture to Non- Agriculture Land No -
as per NALA act, 2016?
17. Whether the proposal comes under Building penalization scheme No -
case?
18. Is water connection available.? Yes -
19. Whether the site falls under un-approved layout and any building No -
plan approval is given or any building exist prior to 1985 on this
site?
20. Whether Proposed site is located in the vicinity of Oil / Gas pipe No -
line?
21. Whether edge of the proposed building is within 30 mts distance No -
from the railway property boundary?
22. 50m within the limits of the Local Authorities. The boundary of the No -
river shall be as fixed and certified by the Irrigation Department and
Revenue Department?
23. Whether the proposed site is located within the distance of above No -
100m and upto 200m from the protected Monuments as notified
under Archaeological monuments and Ancient sites?
 under Archaeological monuments and Ancient sites?
24. Whether the proposed site is located in the vicinity of defense No -
establishments within the distance of 500 mtr?
25. Whether the proposed site falls under Un approved Layout in which Yes -
building approval given?
26. Whether the plot is affected by road widening? No -
27. Whether the height of the industrial building is greater than 10 mtr? No -
28. Whether the height of the building is greater than 18 mtr? No -
29. Whether the height of the industrial building is greater than 18 mtr.? No -
30. Whether the buildings of Educational, Cinema Theatres, Functional No -
halls & other Assembly buildings where plot area is greater than 500
sq.m or height is greater than 6m?
31. Whether the Commercial building height is greater than 15 mtr? No -
32. Whether the size of the plot is above 200.00 sqmt. with height No -
above 10m ?(Only for Municipal Corporations)
33. Whether the size of the plot is above 200 sq.mts?(Only for No -
Municipal Corporations)
H DOCUMENT CHECKLIST
Primary

# Name of the Document Attachment

1. Photographs showing access roads.

2. Link documents (Attested by Gazetted Officer/Notary)

3. Latest Encumbrance Certificate issued by Registration Department.

4. Master plan/ILUP extract indicating the site.

5. Self-Attested copies of Ownership Documents-lease-deed/sale deed etc. giving the

physical description of the plot/property.
6. A Declaration cum undertaking and Indemnity bond by the
Owner/Builder/Developer/LTP in the prescribed Form (Annexure-3).
7. Sign Drawing Plan Pdf And Apllication Form Of Owner

8. Sign Drawing Plan Pdf And Apllication Form Of LTP

Additional

# Name of the Document Attachment

1. Water connection tax receipt

2. Market value certificate from SRO

3. Previous Sanctioned Plan copy with details of approval for the existing building if
any.
I hereby declare that I am the owner/ PAH in possession of the plot on which the work is proposed and that the statement made in
this form are true and correct to the best of my knowledge.

I SIGNATURE
1 Signature of the Applicant Or Firm SK NIZAMUD AHMED S/O SK KHUTUBUDDIN

2 Signature of the LTP Syed Khadar babu (Engineer)