APPENDIX- A1

[See rules 5(1)(b), 75(1), 87(1) and 93(1)]

APPLICATION FOR PERMIT/REGULARISATION
Mylam Grama Panchayat , Kollam

File No: 02503200121001446287 Electoral Ward : Registration No : 1446287

1. Name in capital letters ARUNKUMAR
2. Address:
2(i). Permanent address of the owner 19/, saraswathi mandiram,INCHAKKADU, INCHAKKADU, 691560
2(ii). To which communications are to 19,saraswathi mandiram,INCHAKKADU,INCHAKKADU,Kollam,India
be sent ,Kalayapuram-691560
3. Nature of Compound Wall
development/Construction
4 Details of Plot
Sl (i)Survey No (ii)Resurvey (iii)Extent In (iv)Nature Of (v)Deed No. (vi)Deed (vii) Sub (viii)
. No Ares Ownership Date Registrar's Sub
N Office Division
o
1 319/11 0.091 Settlement 587/10/2 17/05/2010 Kalayapuram kalayap
uram
2 319/11-3 0.121 Settlement 587/10/2 17/05/2010 Kalayapuram kalayap
uram
ix. Ward No. 19
x. Nearest Electric Post/Telecom jkln65
Post number
xi. Taluk Kottarakara
xii. Revenue Village Kalayapuram
xiii. District Kollam
5. Whether the land, if any, No
contiguous to this plot of the
owner shown in the site plan (Rule
6(4)(a)(i)): Yes /No
6 Usage of surrounding plots in general
6(i). North Dry land
6(ii). East Dry land
6(iii). South Dry land
6(iv). West Dry land
7. Whether Government or Quasi No
Government
8. Details of the Construction

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 8(i). Other Construction Details

Whether Government or Quasi

Permit Fee Area in Sqm

Other Rule Description

Other Rule Comments

Coverage Area in Sqm

Special Condition
Existing Building

Number of Well
FSI Area in Sqm

Existing Area
Construction

Parking Unit
Acess Width

Wall Length

Permit Fee
Govt:
Slno

1 Compound Wall × 0 0 0 0 0 × 0 34 0 102

8(ii). Height of Construction in Meters:
8(iii).Total Built-up Area 0
8(iv). Total Covered Area 0
8(v). Total parking area provided inside 0
the building(s)
8(vi). Total Area for F.S.I. 0
9. Basic KPBR Verification w.r.t. proposed plot
Sl.No. Rule Description Provided
No.
1. Access width to the plot 0
2. Coverage in % 0.00
3. Floor Space Index 0
10. Basic KPBR Verification w.r.t. proposed building(s)

Building Type: WALL AND FENCE for Construction 1.

No Mandatory permissible type as per building rules Requir Provide Remarks of

ed d Verifier
1 (28)Access to the building (in metre) <=3.00 4.00
2 (23)Minimum distance from the abutting road/access to other building(s) (in <=3.00 21.00
metre)
3 (29)No. of Four-wheeler parking <=0.00 0.00
4 (29)No. of Two-wheeler parking <=0.00 0.00
5 (29)No. of Parking for Differently abled <=0.00 0.00
6 (29)No. of Parking for Visitors <=0.00 0.00
7 (29)Loading/unloading space (in sqm) <=0.00 0.00
8 (26)Set Backs (in m) 0.00 NA
9 (26)Front <=0.00 0.00
10 (26)Side 1 <=0.00 0.00
11 (26)Side 2 <=0.00 0.00
12 (26)Rear <=0.00 0.00
13 (37)Exit Width (in m) <=0.00 0.00
14 (35(1))No. of Stair case(s) <=0.00 0.00
15 (35(2))No. of Fire Escape Stair case(s) <=0.00 0.00
16 (76(2)3)Rainwater storage capacity (in litre) 0.00 YES
17 (62)SURRENDERED FOR ROADS 0.00 YES
18 (72)SPECIAL PROVISIONS 0.00 YES
19 (77)Solar Assisted Water Heater/Lighting System 0.00 YES

Building Type: WALL AND FENCE for Construction 1.

No Mandatory permissible type as per building rules Requir Provide Remarks of

ed d Verifier
1 (69)Apllication fee for WALL AND FENCE 0.00 YES
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 2 (69)Permit fee per meter length for WALL AND FENCE 0.00 YES
3 (69)Any gate or grill or door or other structure shall not open or project into 0.00 YES
the adjacent property or street
4 (69)Application for the construction or reconstruction of a wall or fence shall be 0.00 YES
submitted in white paper, typed or written in ink and affixed with necessary
court fee stamp
5 (69)Application shall contain documents to prove ownership and site plan 0.00 YES
6 (69)The site plan shall clearly shown all the streets, paths, lanes abutting or 0.00 YES
leading to the plot and also a description of the materials used for the work
7 (69)The Secretary shall, if convinced of the plan and genuineness of the 0.00 YES
ownership, issue permit not later than 30 days from the date of receipt of the
application
8 (69)A wall or fence abutting a street junction shall be sufficiently splayed 0.00 YES
9 (69)The period of the permit shall be valid for one year from the date of issue 0.00 YES
and may be renewed for a further period of one year by filing an application in
white paper, typed or written in ink and affixed with necessary court fee
stamp, within the valid period of the permit issued and the renewal fee shall be
50% of the permit fee
10 (69)Any other Rules applicable 0.00 NA

11. Provisions of Town Planning Schemes, if any, applicable to the construction

11(i).Zoning
Sl.No. Name of the TP Stage(Sanctioned/Pub Zone Permissibility of
Scheme lished) proposed construction
as per the scheme
11(ii).Road Widening
Sl.No. Name of the Stage(Sancti Existing Proposed Building Line Set Back Set back
TP Scheme oned/Publish Width of Width of (in m) Required provided (in
ed) road (in m) road (in m) from m)
Existing road
boundary (in
m)
12. Permissibility with respect to NA
Kerala Conservation of Paddy Land
and Wet and Act 2008 / KLU order
1967
12(i). Type of land as per BTR
12(ii). Type of land as per Data Bank
13. If the application is for
regularisation
13(i). Whether construction completed
or not
13(ii). If not completed, the stage of
construction
14. Details of permit/approved plan
already obtained.
Permit No.
Permit Date , ,
15. Details of Fee paid Application fee Layout scrutiny fee
15(i) Amount 0 0
15(ii) No. and date of receipt ,
16. Details of documents, plans, certificate, etc. enclosed
1. Ownership 2. Land Tax Receipt 3. Site Plan 4. Location Plan 5. Building/Development Plan
17. Details of NOC obtained
Sl.No. Required Whether enclosed or not Details of the NOC / Clearances

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 18. DECLARATION
I ARUNKUMAR hereby declare that the measurements, specifications and other details mentioned above are
correct, complete and true to the best of my knowledge and belief and that I shall abide by the approved
plan and the provisions in the Act and Rules in undertaking the construction.
Place :Kollam
Date :27/08/2021
Signature of the Applicant with Name
19. CERTIFICATE
1. Certified that the site plan is prepared after verification of ownership document and site and the
measurements shown are found to be correct.
2. Certified that the building plan is prepared in accordance with the provisions in the Kerala Panchayat
Building Rules 2019, Kerala Panchayat Raj Act, 1994 and the provisions contained in the sanctioned Town
Planning Schemes, if any.

Signature
Name :VISHNUDAS.M
Reg.No. :E-5369/15/EA-1229/KLM
Address Kesaveeyam
Kalayapuram po
Kottarakkara
(Registered Architect/Engineer/ Town Planner/Supervisor)
Place:Kollam
Date :27/08/2021
20. UNDERTAKING
I VISHNUDAS.M hereby undertake that the building construction and/or land development will be carried
on/ being carried on/ was carried on as per the approved plan and permit in accordance with the rules in
force.

Signature
Name :VISHNUDAS.M
Reg.No. :E-5369/15/EA-1229/KLM
Address Kesaveeyam
Kalayapuram po
Kottarakkara
(Registered Architect/Engineer/ Town Planner/Supervisor)
Place:Kollam
Date :27/08/2021
21. VERIFICATION
Certified that the extract of the Building Permit Application prepared electronically on 27/08/2021 at
was verified by me in details and to the best of my knowledge and belief the entries made there in are
correct.
22. Permit Fee Rs. 102

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