ULHASNAGAR MUNICIPAL CORPORATION CITIZEN FACILITATION CENTRE SUBJECT: ISSUE OF CONSTRUCTION COMPLETION CERTIFICATE / USE PERMISSION 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 Information Layout approval Number (if any) Date: Construction Permission Number Date: Name of original owner Name of the Power of attorney holder (if any) Town/City: Taluka: Survey/Block/Barrack No.: C.T.S. No.: Part No./Sheet No.: Plot No./Unit No.: Area of Land (sq.mtr.) Citizen Identification Number Road/Street/Lane: Ward Committee No.: 1 [ ] 2 [ ] 3 [ ] 4 [ ] Property Number (Computerized) Necessary Particulars about above service: Head Particulars 1 Name of the Company of Architech/Engineer 2 Name of licensed Architech/ Engineer 3 Address of licensed Architech/ Engineer Pin 4 License Number of Architect Date: 5 Type of Construction permission (Tick [ ? ] whichever applicable) [ ] Residential [ ] Non Residential/Commercial [ ] Mix 6 Number of Flats / Blocks in building Necessary Enclosures related to above application are enclosed as under. (If enclosed tick [ ? ] or not enclosed tick [?] ) Enclosures Yes/No 1 Application in specified format for part construction completion certificate (Appendix 'J' of D.C Rule) [ ] 2 Assurance letter for part construction completion certificate on Rs.50/- stamp paper (Appendix 'L' of D.C Rule) [ ] 3 Structural Stability Certificate (Including Earthquake resistance) issued by structural Engineer. [ ] 4 Attested copy of Non Agricultural Permission [ ] 5 Three copies of Schedule II [ ] 6 NOC from Fire Brigade if building is having more than ground + four floors. [ ] 7 NOC from Department of Chief Engineer (Electrical) of State Government for lift, if building is having more than ground + four floors. [ ] 8 Possession receipt regarding transfer of area / land; covered under various reservations of Development Plan and DP Roads, to Corporation. [ ] 9 Eight copies of the map of total completed work / construction (one on cloth) [ ] 10 No dues certificate of Property Tax [ ] 11 No dues certificate of Water Tax [ ] 12 Three copies of the maps & cross-section showing gutters, nalla ; constructed as proposed & approved by Stromwater Drainage Department at the time of giving Building Permission. [ ] 13 Three copies of maps (with measurements) showing septic tanks/Soak pit/ Drainage Lines constructed as proposed & approved by Underground Drainage Department at the time of giving Building Permission. [ ] 14 True copy of Building Permission for Underground Drainage Department [ ] 15 True copy of the NOC issued by the Underground Drainage Department at the time of giving Building Permission. [ ] 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):
