| Name of the Applicant
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| Address and Mobile Number of the Applicant
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| State
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| District
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| Local Body
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| Name of Panchayat or Muncipality
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| Type of Construction
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| Type Of Building
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| Survey Number
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Multiple survey nos are not allowed |
| Sub Division Number
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If there is no sub division number,
Kindly mention the sub division number as 0 |
| Area Of Building Contruction - Ground Floor (Sq.mt)
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| Area Of Building Contruction - First Floor (Sq.mt)
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| Total Area Of Building Contruction (Sq.mt)
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| Area Remaining Vacant Land (Sq.mt)
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| Date:
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yyyy/mm/dd |
| I declare that the above furnished information is true to the best of my knowledge and belief.I also undertake to
comply with condition subject to which the permission may be granted.
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