Annexure W1

Format for Land Evaluation by LEC

Retail Outlet Site Evaluation Parameters

1. Advertised Location: 2. Regular / Rural:

3. Sr. No. As Per Advertisement: 4. Category:
5. Offered Land Details:
a. Land (Plot) No.: (Khasara/Khatauni/Patta/Dag/Gatta/Gut/Survey/Plot No. Etc.)
b. Revenue Village: c. Tehsil: d. District:
e. State:
6. Offered Land Dimension: Frontage ___ Meters, Depth ____ Meters, Area ___ Sq. Meters
7. Distance Of Land From Prominient Landmark: ______ Meters From ___________ (Name Of
Landmark)
8. Distance Of Edge Of Land (Along Front Of Land) From Centre Line Of Road: ______ Meters

9. Width Of Right Of Way (Row) Of Road: ___________ Meters

10. Name / No. Of The Road Abutting The Offered Plot: (NH/SH/MDR/ODR/Road no. or name of
road)
11. Status Of The Road Abutting Offered Plot As On Date Of Advertisement: (Required to be checked
only for Rural RO locations and locations where road types/nos. are used in naming a location)
12. Latitude / Longitude Of Any Point Within The Plot Of Land Offered By The Applicant /
Representative: ________ LAT _________ LONG
13. Ascertain the offered land/plot is as per advertised location:

14. Name Of The Applicant:

EVALUATION PARAMETER YES NO

1. Offered Land Meets
a) Minimum frontage as specified in advertisement
b) Minimum depth (as specified in advertisement) perpendicular
to the frontage at least at one place after leaving the ROW line
c) Minimum area as specified in advertisement
2. Offered Land Is Within Advertised Area / Stretch
3. No High Tension Line (> 11 Kv) Is Passing Over The Offered Land

4. Offered Land Meets Nhai Norms (applicable only in case offered land is
situated abutting National Highways)

Recommendation Of LEC Yes No

Offered Plot Found Suitable For Development Of A Ro

If Offered Land Is Not Found Suitable, Detail Reasons For Non Suitability of Land

1.
2.
3.

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LEC To Verify Layout Of The Plot With The Layout Drawing Uploaded By The Applicant. Any Deviation
To Be Highlighted.

Member 1 Member 2 Member 3

(In Case Of NH)

Signature of concerned officer at Division / Territory / Regional Office

Name & Designation

Signature of Divisional / Territory / Regional Office in-charge

Name & Designation

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 Annexure W2
Layout Sketch of land offered by the applicant

1. Advertised Location: 2. Regular / Rural:

3. Sr. No. As Per Advertisement: 4. Category:
5. Offered Land Details:
a. Land (Plot) No.: (Khasara/Khatauni/Patta/Dag/Gatta/Gut/Survey/Plot no. etc.)
b. Revenue Village: c. Tehsil: d. Disctrict:
e. State:
f. Name / No. Of The Road Abutting The Offered Plot: (NH/SH/MDR/ODR/Road no. or
name of road)
6. Name Of Applicant:

I hereby confirm that the above mentioned details of the land offered by me are correct and
the plot of land which has been inspected by the Company Officials on __________ which is
more specifically indicated in the sketch / layout below, is the same plot of land which has
been offered by me in my application for development of retail outlet at the location
mentioned above. Further, I also confirm that:-

i. The plot of land offered by me meets the minimum advertised dimension / area, after
leaving Right of Way (ROW) line of the road and is situated abutting the ROW of the
road.
ii. The offered plot of land is not notified for acquisition.
iii. I / The Land owner(s) am/is/are in Possession of the land from the beginning / edge of
ROW line.
iv. There is no other land (including Govt. land) between ROW and offered plot.

I also understand that in case any of the details mentioned above are found incorrect or the
site is found unsuitable by the Corporation for any reason whatsoever then I would have no
claim on the dealership of this location.

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 ILLUSTRATIVE LAYOUT SKETCH OF OFFERED LAND

NAME OF
OFFERED PLOT PROMINIENT
____LAT ____LONG LANDMARK / ___ Mtrs.
KM STONE (DISTANCE
___ Mtrs. FROM ROAD
(DISTANCE OF INTERSECTION)
EDGE OF
RIGHT OF WAY ___ Mtrs. PLOT FROM
(ROW) CENTRE LINE
OF ROAD)
___ Mtrs.
(DISTANCE FROM
NEARBY RO) ___ Mtrs. ___ Mtrs. (DISTANCE
FROM LANDMARK / ___ Mtrs.
___ Mtrs. __ Mtrs. (DEPTH) (DISTANCE FROM
KM STONE
CHECK BARRIER /
TOLL GATE)

RO 90o

___ Mtrs. (FRONTAGE)

NAME OF
PROMINIENT
LANDMARK /
KM STONE
ROAD MEDIAN / DIVIDER (IF APPLICABLE) ROAD MEDIAN

WIDTH OF ROW
___ Mtrs.

CENTRE LINE CHECK BARRIER

TO ______________ OF ROAD / TOLL GATE
TO ______________
(NEAREST DESTINATION) (NEAREST DESTINATION)

___ Mtrs.
(DISTANCE ROAD NO. / NAME OF ROAD
FROM ROAD (AS ON DATE OF ADVERTISEMENT)
INTERSECTION)

Date : Name & Signature of the applicant

/ Representative of applicant

Member 1 Member 2 Member 3

(in case offered plot
is situated on NH)

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