APPLICATION FOR INDUSTRIAL PLAN APPROVAL (Through: General Manager, Dist. Industries Centre) To, The Vice-Chairman, Urban Development Authority, Visakhapatnam-530 003 (A.P.) Sir, I hereby give notice that I intend to carry out development in the site to erect / to re-erect demolish / renewal / extension / addition / change of use in the building ___________________________________________on / in plot No.____________ Land, Town and Survey No.____________________ Block No.___________________ situated at road / street______________ town / village _________________. I forward herewith the following plans and statement (item 1 to 10) whatever is applicable, in quadruplicate signed by me (Name in block letters) _____________________________ and the Licenced______________ Licence No.__________________ who has prepared the plans, designs along with copies of the statements / documents. 1. Top plan to a radius of 100 m. 2. Site plan. 3. Sub-division / Layout plan. 4. Building plan. 5. Service plan. 6. Parking arrangements. 7. Particulars of development. a. Horse Power. b. Product Mix. c. Nature of Industry - Small scale - Gramodaya Scheme. d. Other operation details whether it is pollutant heavy industry. 8. N.O.C. from Air & Water Pollution Board, if it is a pollutant and hazardous industry. 9. Ownership title. 10. Urban Land Ceiling Clearance certificate from Competent Authority. 11. Draft drawn in favour of Vice Chairman, VUDA towards Development Charges / Building Licence fee for Rs.__________________. I request that the proposed development / construction / extension may be approved and permission accorded to me to execute the work. Signature of Licenced Surveyor / Engineer / Architect with stamp. Signature of Owners. Name of Owner. Address of Owner.
