Application Form - Minor Irrigation Machineries. From To The Assistant Executive Engineer (AE) Agricultural Engineering Department . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sir, I request for the allotment of Hand Boring Set / Rock Blasting Unit / Power Drill / Long Hole Equipment to work in the below mentioned village for 5 days or for required number of days to complete the work. 1. Workspot : 2. Field SF No. : 3. Village : 4. Purpose : Agricultural Non Agricultural 5. Total Extent : ...... acres 6. Category : Marginal Farmers Small Farmers Other farmers 7. Community : Adi Dravidar Scheduled Tribe Other Community Women I have paid Rs. vide Receipt No....... dated ....... towards site Inspection charges and Rs. vide Receipt No. ..... Dated ...... towards advance hire charges. I here by agree that I have gone through the rules and regulations regarding hiring of Minor Irrigation machinery and equipment and accept the same. I accept to pay the additional hire charges and other miscellaneous fees as fixed by the Agricultural Engineering Department and accept to changes in the hire charges, and to the rules and regulations of the hiring of Minor Irrigation machinery, if any made by the Government. I hereby give my consent to allow the officials and staff of Agricultural Engineering Department to inspect and execute the work at worksite and to release the machinery and equipment of department after completion of the work. I hereby assure that I will handover the machinery and equipment of Agricultural Engineering Department in office If no other party / Applicant are available. I assure that I will provide safety to the machinery and equipments of Agricultural Engineering Department without causing any loss to the Department and to the Government. Signature of Applicant. For office use only:- Please accept Rs. .. . Towards workspot inspection charges and Rs. towards advance hirecharges and issue receipt. Section Officer
