[Annexure – C]

Refusal of Application

From: The Commissioner/Chairperson/Chairperson of the Board of Administrators/ Executive Officer

…………..…………………… Municipal Corporation/Municipality/NAA

To: ……………..……….
…………………………….
…………………………….
(Name and Address of the Applicant)

Sub: Permission for Construction/ Erection of Ground based or Roof based Mobile Tower for
………………….......……………..………….. (Name of Project) in the …………………..….......
……… ………………… (Name of work site), Premises No./ Holding No. ……………, Plot No.
……………, Street …………………………., Ward No. …..……… & Borough No. (if any)
………..…..

Ref: Application No. ………………………………….. dated ……………. of the applicant

Dear Sir/Madam,
With reference to your application mentioned above, the ULB has decided to refuse the
permission in connection with Construction/ Erection of Ground based or Roof based Mobile Tower for
……………………………………………………………..….…….. (Name of Project) in the
…………………………………………………….……………………… (Name of work site), Premises
No./ Holding No. ……………, Plot No. ……………, Street …………………………., Ward No. …..
……… & Borough No. (if any) ………..….. for the following reasons:
1.
2.
3.
.
.
.

Yours sincerely,

_____________________
Commissioner/Chairperson/Chairperson of the Board of Administrators/ Exe