ULHASNAGAR MUNICIPAL CORPORATION CITIZEN FACILITATION CENTRE SUBJECT: CERTIFICATE REGARDING - "BUSINESS PERMISSIBLE AT PROPOSED LOCATION" Token Number (For Office Use) Date:- / / (If Citizen Identification Number is given, do not fill below Details) Applicant's Details: Last Name/ Surname Name Father/Husband's Name Details of Society (If Application from Society): Name Of Society: Designation Address: Head Information House/Building/Soc. Name: Flat/Block/Barrack No.: Wing/Floor: Road/Street/Lane: Area/Locality/Town/City: Taluka: Pin code: Ward Committee No.: 1 [ ] 2 [ ] 3 [ ] 4 [ ] Electrol Panel No.: Telephone No. (if any): Contact Person: Email Address (if any): Information of Property: Head Particulars Type of Property (Please Tick [?] as applicable) [ ] Land [ ] Building Property Number (Computerized) Necessary Particulars about above service: Head Particulars 1 Address of the property / land Pin 2 Construction Permission No. Date:- 3 Construction Completion No. Date:- 4 Nature of Business Citizen Identification Number Necessary Enclosures related to above application are enclosed as under. (If enclosed tick [ ? ] or not enclosed tick [?] ) Enclosures Yes/No 1 Certified copy of the Construction Permission and Maps. [ ] 2 Certified copy of the Construction Completion Certificate and map of completed construction [ ] 3 Copy of map showing location of shop. [ ] 4 NOC from Developer / Society / Housing Corporation [ ] 5 NOC for the place (Attached any one of the following) 1. If the applicant is owner of the business place then proof of ownership/agreement copy 2. If applicant is tenant, then NOC from the owner/ power of attorney holder of the place on the stamp paper of Rs.20/- 3. If the applicant is power of attorney holder then its true copy [ ] Declaration I/We..................................................................................................state on solemn affirmation that the above information is true and correct with the best of my knowledge. If the information given is found wrong then I/We shall be held legally liable for its consequences. Date:- Applicant's Signature ( ) The document may please be delivered to:- 1. Self/Nominated Person [ ] a) C.F.C. [ ] b) Camp No. [ ] Name of Nominated Person (________________________________________________) 2. By Post a) U.P.C. [ ] b) Register A.D. [ ] 3. Courier [ ] (Not to be filled if address is same as above) Correspondence Address:- Last Name/ Surname Name Father/Husband Name House/Building/Soc. Name: Flat/Block/Barrack No.: Wing/Floor: Road/Street/Lane: Area/Locality/Town/City: Taluka: Pin code: Email Address (if any):
