Particulars of construction proposed/ completed
(For item 1&3 please check the appropriate cell with)

1. Nature of construction :  
  a) New construction :            * b) Alteration and /or / additions to existion building.*
2. Place of construction : ______________________________________(Urban/Rural *)
3. Type of construction :  
  a) Residential quarters
  i) Family quarter __________________________________________________________________
  ii) Non family dwelling places (Such as hostels, dormitories and Lodging Hostels and Clubs)
  b) Industrial buildings (Factories, Plants, Workshop etc.) __________________________________
  c) Commercial buildings (Shops, warehouse; Offices Public garages etc.)______________________
  d) Institutional buildings (School, Hospitals and dispensaries, religious building etc)
  e) Other building (Public buildings, Public libraries, amusement building, etc.)
4. Total plinth area __________________________________________________________(in meter's)
5. *Estimated/Actual cost of construction Rs. _______________________________________________
6. Total floor area in all floor (including basement, If any)____________________________________
  ________________________________________________ sq. Meters
7. Number and type of drilling unit in the construction.
Number and dwelling units
Alteration and/* or
New construction addition to existing
Resulting in dwelling Units.
  1.- room units
  2.- room units
  3.- room units
  4.- or more room units
  (Particulars for the following applying for occupancy certificate only)
  8. Number and date of issue of Authorisation certificates __________________________________
  9. Date of commencement of construction ______________________________________________
  10. Date of completion of construction __________________________________________________
  Date __________________________(Signature of the applicant)
  Name and address of applicant
  For office use only) in block letters
  Reference number of application
  Number and date of issue of Authorisation/occupancy certificates
  Strike off the alternative not required.
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