® Nellore Municipal Corporation ‘TOWN PLANNING SECTION BUTLDING APPLICATION FORM BA No. 1031/1 1S6/B/NMCIKSNI2023 Date of submision 02 July, 2023 ‘Sub: Bullding Application for grant of permission for Construction of Bullding Permission Notice us 209 & 227 of APM, Act, 1965 /428 8 433 of HMC Act, 1955. [A JADDRESS OF THE APPLICANT 1 |Name (in Ful) [Ch. JANARDHAN 2 [Fim Name E 3 [Door NovFlat No. 287171820, Kissan Nagar, Revenue Ward No 28-1, Nelore 4 Roadtest INA 5 [Locality / Mandal Ina ve ly [SPER NELLORE PT? [21 41°] ° 15 (7 [oisie INELLORE | 8 [Phone 7 Mabie No. [eot0as7108 [9 emai \VKC.STRUCTURAL@GMAIL.COM B [LOCATION OF THE PROPOSED SITE 1 [Ward No. [Block No. [Ward 03 Na | [2 [layout Location [Aliram om 13 [IRS Ne. INA [a [RST TS Ne. [seer 15 Plot No. INA [© [Premises NoJDoor No, _[28-1-1020 [7 Roaaisteet IMAIN ROAD 8 [locality IKISSAN NAGAR @ [City Town [Disvict [Nellore Neore ¢ [DETAILS OF BUILDER /LICENSED PERSONNEL Pes # Name ‘Addres License No. Valiaty 7 [Chitatury Lokesh (Structural [Door no 1r2020/Licensed Engineer) '196,kasipalem,buchireddypalem, Structural Inolore [EngineeciNUDA D [DETAILS OF PROPOSED CONSTRUCTION F. 35 [|Site Area (69. mt) TAs per Documents ie [As on Ground | 2 [Total Floor Area (69. mit) 3 [Fotiet Area (sq. mi.) I 4 |No. OF Units 2 [& |peTALSoFBULDING | a 1 No.of Blocks i [Total Bult Area (sq. mi.)[191.16 @ scanned with OKEN Scanner% | Bunaingname | use | subueo | Type _[80M|No. ofFloors| Bifurcation of Floor | 7. [GH GANARORAN) Resdentat nail ca oa eu estaont Foor ane |g [outing |GROUND 55.58) FLOOR RST Er} . FLOOR F_ [AUTOCAD FILE mm Pee 7 [AMoCAD Fle 5x27 § JANARDHAN wo G [APPLICATION CHECKLIST a te Description esto Remarks 7 [hehe proposed siois wit he 20 Mi dtanceirom heraiway| NA brosery?ilyesobiam NOC tom Ralay Departmen. | 2 Whether proposed sie fs wit the Ar Funnel Zone /Voniyat | WA laipon” 37 [Whether Proposed ste is located th voy of O17 as pie | NA line? (in case of Sites inthe vicinity of Oil/ Gas pipelines, clearance distance and other stipulations of the Respective Authority shall be | eompled win. The O1/ Gas Authors shal also spect the (clearances required strotch wise to Local Body.) | Jwetner Proposed sts located inthe viciy of Detense NA [Establishments (500 Mi)? ‘in case of sites abutting to Defence | lestabishments, NOC from Defence authorities need not be insisted. However it will be the responsibilty of the applicants to follow the [applicable rules as prescribed by the Defence authorities in their [rules G.O.MS no. 7 MA dt: 5.1.16") %._ Whether proposed ste area is more than 60 ha? If yes, whether NA INOC of SEIAA is submitted [Whether site falls within 600m from HTL of Coastal zone? if yes, NA i whether NOC of CZMAis submited. 7. Whether site falls within 30m of Heritage buildings? Wyes, whether | NA [+ INOC is obtained. &. |Whether the size ofthe plot is above 200 sq.mts?(Only for NA Municipal Corporations) '. [Whether the Commercial bulding height is greater than 15 mtr? NA i 70. [Whether the size of the plot is above 200.00 samt. with height NAF | labove 10m 2(Only for Municipal Corporations) Ti. [Whether the buildings of Educational, Cinema Theatres, Functional | NA |- halls & other Assembly buildings where plot area is greater than 600) [sq.m or height is greater than 6m? 72. |Whether the height ofthe building is greater than 18 mtr? NA i 3, [Whether the height of the industrial bulding is greater than 18 mtr.2| NA | 74. [Whether the height of the industrial building is greater than 10 mir? | NA 76. [Whether the plots affected by road widening? —| 76. |Whether the proposed site fas under Un approved Layoutin which | NA J building approval given? 17. [Whether the proposed site is located in the vicinity of defense NA lestablishments within the distance of 500 mtr? 7, [Whether the proposed site is located within the distance of above | NA |- |s00m and upto 200m from the protected Monuments as notified lunder Archaeological monuments and Ancient sites? 70. 150m within the limits ofthe Local Authorities. The boundary of the | NA |- Fiver shall be as fixed and cerified by the rigation Department and [Revenue Department? 20. |Whether edge of the proposed building is within 30 mits distance NA 1 | {from the railway property boundary? _ @ scanned with OKEN Scanner[Whether Proposed ste is located in te vicinity of Oil/ Gas pipe ra ine? 1a north eas nde u-poroved you and any bung | WA 1 |plan approval is given or any building exist prior to 1985 on this liter 1°23. [is water connection available.? NA 7a later he proposal comes unde Bldg penalzaton scheme | NA ase? FE [bane vat carcate sued by he Revenue Doprinoni WA | [deviations are made to Sanction plan) "a terns eh ofr ug TTC? Wa | 27. |N.O.C from Andhra Pradesh State Fire Services & Disaster NA 17" Response Deparment 2a: | og ot Buin > 10 Ws an uo 16 Wes, Cormerdal Usage] NA 22, | ght of Bung > 18 Ns and oto 1 Ms, ReidontalUsge | NA 130. |If Height of Building > 15 Mtrs and upto 18 Mtrs, Commercial Usage NA if eight of Buldng> 18 Mus Any Usage Wa 152: [heer the Landis conve Agicture to Now AgcutureLand | WA 7 asperNALa oc 2016" 33. |Whether Environmental Clearance is required for proposed NA | Ibulding? { GA Whether 70% of EWSILIG on te project ale oF 75% a wa WA umber of unis provide win sel of hm om te project st Th Group Houshe/Devetoment projets? | 3. Whether ial under Aoproved Layout RSPPt pan ofLRS | WA Layout batt repuorz® a ‘36. [Whether any Approved Pian given in proposed site? NA a7 [eter te proposed ses abring io NHISHS? WA 2 eter he proposed ais cated with te tance of above | NA oom and upto 200m om he pteted Monurens 8 nailed nor kecestopeaT monuments and Ancent ses? 1G: Jeter te Proposed sts abuting noted forest? WA Za eter roped sesso bed of water bods The ver orrala] NA Sndin he Fat Tank vel (TL) oan ake, pon, cher or oma scam ans? TF ther incase the ands declared as Supls? WA 72: Whee roosed ae comes under part of Survey Nos? WA 7B: Ifyou aro Airport cy, Do you have NOC rom AAT? NA 7H: [Bo you want to app NOC rom AA? WA 76. Weer NMA NOC savolabie wih ou or proposed eorauaion | NA ses? 7 |B» you want to apy NO from NMA? wm a. |Rooroac oad canal bund cossing the canal wih parmision to | NA consructelvr 7B_ Whether ECBC is complied for commerdal balding or oher NA NovResitnts! Budingspropsel having pot rea more than 000 Square Mero” but up rea o 2000 Square Meters or ho sulting Mottpexes, Hosp Hla, and Convenon Geter Ith mespecve ot bt up area? “B: ether Th Proposals of Group Oavelopment Scheme? NA 50, |Whehe proposal alsin Ubaisabl Land we zone? WA i jhather the propesal sn Ubarsabe Land vse zone? WA 7. |Whater The Terran is Undated NA 7: Whether he buldng is pre-corfie om IGBG (dian Green WA @ scanned with OKEN Scanner{Buiding Council) or LEED India or TERI or GRIHA following the G. (0. Ms. No, 30 Dated: 28.01.2014 to avail incontvas under rule 145. ‘54, [ls rain wator harvesting structure provided inthe site? NA 55, [ls solar rool top systom is installed in tho sto? NA | NA [5 hetr The Popes Bun Is AeadyConsivaed Wi ‘Approval But Satisying Presont Rules an 57, [isthe Waste Water Recyeio & Rouse systom provdedintho so? | NA |- '58. [Whether proposed construction is an Educational building? NA fe 50, [Whether proposed sit has VLT/Assessment number? nA i | 60. [is CLU's applicable? NA | 1 [DOCUMENT CHECKLIST. T= ® J Primary [Name of te Document [Atachmont ] IPhotaraphs showing access rads. | |Link documents (Attested by Gazetted Officer/Notary) Latest Encombrance Certificate issued by Registration Department. ‘Master plan/ILUP extract indicating the se. TSell-Attested copies of Ownership Documents -lease-deed/sale deed ete. giving the ‘physical description ofthe plo/prozety. 'k Declaration cum undertaking and Indemnity bond by the | lowner/Buider/Developer/LTP in the prescribed Form (Annexure-3) ‘ign Drawing Plan Pa And Aplication Form Of Owner ‘Sigh Drawing Plan Pat And Aplication Form OF LTP 1 1 hereby declare that I am the owner/ PAH in possession of the pot on which the work's proposed and thet the statement made in this form are true and correc tothe best of my knowledge. 1 [SIGNATURE ss iirimeen ls 1 ne of pan Fm Eensmnouan CL 22° LS Sane of he ara Lesh (Strut cer) @ scanned with OKEN Scanner