FORM 1C (Prescribed under Rule 3) APPLICATION FOR PERMISSION TO CONSTRUCT, EXTEND OR TAKE IN TO USE ANY BUILDING AS A FACTORY 1. Applicant's Name Calling (Designation) Address (Residential/Official) 2. Full name and postal address of the Factory 3. Situation of the factory Extent of land .. State ... Commune ... Town or Village ... Nearest police station ... Nearest railway station or steamer shaft ... 4. Particulars of plant to be installed ... 5. No. of shifts proposed to be worked .. 6. No. of workers to be employed per shift .... Men....... Women....... 7. No. of H.P to be installed .... (Space for Rs.1.50 court fee stamp) Date: Note: This application shall be accompanied by the following documents: a) A flow chart of the manufacturing process supplemented by a brief description of process in its various stages b) Plans, in triplicate, drawn to scale, showing (i) The site of the factory and immediate surrounding including adjacent building and other structures, roads, drains, etc. (ii) The plans, elevation and necessary crosssections of the various buildings, indicating all relevant details relating to natural lighting, ventilation and means of escape in case of fire. The plan shall also clearly indicate the position of the plant and machinery aisles and passage ways c) Such other particulars as the Chief Inspector may require.