Applicant Photograph

GOVERNMENT OF ODISHA
ENERGY DEPARTMENT
ELECTRICAL LICENSING BOARD, ODISHA, BHUBANESWAR
FORM-F
(REGULATION 17)
Workman Permit (On Exemption)
(Lineman Permit-MV)

I do hereby certify that BHABAGRAHI SAHU has been granted (Lineman Permit-MV) on this day and permitted to
work in electrical installation the State of Odisha under direct supervison of a person holding appropriate category of
Supervisor certificate of competency for the purpose of Regulation 29 of the Central Electricity Authority (Measures relating to
Safety & Electric Supply) Regulation, 2010 (as amended).

Name of the Permit Holder - BHABAGRAHI SAHU

Son of - DHANESWAR SAHU

Address - DHAMA,MANESWAR,SAMBALPUR

Date of Birth - 10/05/1996

Mobile No. - 7894535956

Email Id - bhabagrahisahu69@gmail.com

Category of Permit - Lineman Permit-MV

Permit No. - SMB 2972 26

Permitted to work in overhead and
Type of work - underground installation including
equipment upto 650V
Date of issue - 22/09/2021

Valid upto - 20/09/2026

Working under - w.e.f.

dgSign2031LocnDyna
Supdt Eng-cum-Electrical Inspector Sambalpur
22/09/2021

Applicant Signature

**** This is a Computer Generated Document And Does Not Require Signature ****
N.B.: Please Note:This document is not valid unless It is checked / verified with official website: - https://eicelectricityodisha.nic.in
Where vigilance ends, accidents begin. Take precautions against Accidental Contact with Overhead Powerlines. Don’t give an excuse, stop energy
misuse.

Reference No: WP/2021/05588 To View: https://edistrict.odisha.gov.in/t/TIxIb/372BB7F7 Token No: 372BB7F7