FORM-IV [See Govt. of India's decision No. 2 below rule 16] Form of report/application for permission of the Govt. for the building of or addition to, a house Sir, This is to report to you that I purpose to build a house make an addition to my house. This is to request that permission may granted to me for the building of a house/making addition to my house. The estimated cost of the land and materials for the construction/extension of the house is given below :- LAND : (1) Location (Survey numbers, Village, District, State) (2) Area (3) Cost BUILDING MATERIALS ETC : (1) Bricks (Rate/quantity/cost). (2) Cement (Rate/quantity/cost). (3) Iron and Steel (Rate/quantity/cost) (4) Timber (Rate/quantity/cost). (5) Sanitary fittings (cost). (6) electrical Fittings (Cost) (7) Any other special fittings (Cost) (8) Labour Charges (9) Other charges, if any TOTAL COST OF LAND AND BUILDING 2. The construction will be supervised by myself/The construction, will be done by ......35 I do not have any official dealings with the contractor, nor did I have any official dealings with him in the past. I have/had official dealings with the contractor and the nature of my dealings with him is/was as under : 3. The cost of proposed construction will be met as under :- Amount (i) Own Savings (ii) Loans/Advances with full details (iii) Other sources with full details Yours faithfully