Tome "REPUBLIC OF THE UNION OF MAVANMAR Yangon Regional Government DRA-001, Yangon Cty Development Committee Engineering Deportment (ulin) DECLARATION OF RESPONSABILITY OF THE APPLICANT/ LAND OWNER Pa ‘1 Application Number (oe fied y YeOC) Zsite Paaaress Ward ‘ownshi Postal code: ste area in acre: Block No: Lot No: ‘3. Applicant /Lond owner's details ame: ‘Address ward Postal code: Township: Prone No: Emall: @ Is there an representative person acting on behalf of he applicant? Ties 7 no Name: Adress [ware Postal code: “Township: Phone no: mall: @ Registration number ofthe general or special power: Date of issue: ‘4. Declaration ond signature Jnentonnea inthe application form attaches to tis deciaration hereby decore being ful aware of rights and duties regarding the present application tothe buldng/ demotion permit concerning the project 2m completely aware that any changes regarding the cere professionals in charge f the design o supervision ofthe construction / demolition works or any changes regarding the licensed contractor would occur, sall otf YCDC in wetting immediatly and the construction / demotion wl be opped unt wnew certified profesional and/ora new lensed contractor wl be apoited. coir that, to the est of my/our knowledge, any facts state nthe appleation document are tue and accurate and any opinions even ae the genuine opinions ofthe persons) giving ther. I understand that any ase or misleading Information even regarding the land ownership may resin some adtiona delays regarding the issuance ofthe approval mprniple and/or the buldng / demolition permit ‘Name ofthe applicant land owner Signature Op «CHO CHO. er Drscot /1 oft