THE KOLKATA MUNICIPAL CORPORATION Name : ........................................ Address : ......................................... Phone No. : ......................................... Date : ........ To The MunicipalCommissioner The Kolkata MunicipalCorporation Subject: ApplicationU/s 421 ofthe KMCAct1980forapproval ofasitoestlernHuse. e tabisha CemoialoI/eryapldhtnspifoe o/urinenion We hebpyunerte secioeciedabvfmyotttoestlernoofrywitegulios cnain abisha Cemoialhuse incnomithratnoted inthe notificationdated22ndSeptember2004 andthe KMCAct,1980. Insupotfhpicio,/omakhol winatt protisaplatnIWewishtetefogstemens aboutthe site: 1. Assessee# ................ Borough# ...... Ward#.... 2. Premises #..................................... .................................... ..................................... (a) Totalarea ofPlot: (i) as perdocument..........sq.m. (ii)as perphysicalmeasurement.......sq.m (b) Boundaries onthe; North................ South............... East................. West................ (c) Existing Coveredarea ingroundfloorofthe site: ....... sqm. (dayutPlfhrteexinealnhdaillo ) Loanote stucuristg atsitog witetedfor wise area ofthe structures,theirsanctioned use,required car parking as perprevailing building rules and existing carparking facilities inthe premises. (e) Existing totalopenarea insite being ......... sq.m. outof whic..... .m.ispoooboassembyo h.....sqrpsedteusedfrlf peol......m.ispooobophs/ pe,...... sqrpsedte usedfratwaypassages/driveways and ......... sq.m. is proposed to be usedfopkgo......csaspteat hayout rarinf.....arerhacedlplanwhereinitis alsoshownthat....... Nos. ofcarparks are requiredforthe othersanctioneduse/requirementofthe building and............ Nos. carparks are providedforuse bythe persons visiting the ceremonialhouse. 3. I/We confirm that the site is legal y owned by me/us and the ownership particulars are confirmedbythe records ofassessmentofKMC(CopyoftaxBil or AssessmentRegistertobe enclosed): 4. CpfBdgScioanenlsedoyouilinantnPlco: (Ifa building exists atthe site) 5. Site Plan of the proposed site for ceremonialuse annexedinsixcopies: 6. Space proposed to be used as a Ceremonial House in the premises idenifEnte enlsedpantiedinRDohcol: 7. Number of Hospitals within 500m. idenifENohcoltiedinGREnte enlsedpan 8. Number of places of worship within 500enifELnte enlsed m.idtiedinYLOW ohcoplan 9. NumberofEducationalInstitute within 500m. identified in BROWN on the enclosedplan 10. Nature and/ortype ofthe building as per Municipalrecords: ......Numbers ......Numbers ......Numbers .............. 11. Number of car parks dedicated for the ......Numbersceremonialhouse: 12. Capacityofthe CeremonialHouse: ........Persons 13. Briefdescriptions ofthe equipment instedatsitrdg rmenf ........ al e egarinteatto.......the gaseous discharge and the ef luent ................ generated: ................ ................ .............. 14. Characters and width ofthe means of access tothe site onits (i) North: .................. (ii) South: .................. (iii) East: .................. (iv) West: .................. 15. NumbfDwel g uns sitedwitineroinituath300mtrs. radious: .........Numbers 16. Maximum quantityofwaterrequiredfor eachdayofceremony: ..........Lit 17. Briefdescription ofthe Fire detection andpevtnfilies avabe atsit.................... ...res renioacitaille: .................... .................... .................... .................... .................... .................... .................... .................... .................... Signature ofthe Applicant(s) 18. Anyothersubmission: .................... .................... .................... .................... .................... .................... InsfrApplsadNeyE l:ncosures cessar nitcan o ittsrucon (Ahpicioodbmit oiesalnh )Teaplatnshulesubedinsixcpogwit; (i) Pls dawnohol winal anrntefogsces; a. LayoutPlan(s) -1:100 itan b.SePl-1:600 c. LocationPlan -1:4000 (ii) At ed/Ntisedpoooyosantnpan estoarhtcpfciol (iii)Phtcpfur tMunipT/ssessmenBooy oooyoCenicalaxBil Atokcp (iv) At estedcopyofthe Purchase Deedofthe Applicant(s). (Bhplan(odcefyrhcooifatnan)TeApicts)shularul eadteenlsednticiod applyinterms ofthe notification. (C) The procedure forpermissionu/s 421 forapprovalofa site for Cernusefrarotisaplatn emoialoms a ptfhpicio.
