Appendix A — Form for Land Use/Development/Building Permit

First Application to Develop, Erect, Demolish or to Make Alteration in any Part of the Building

Type of intended work: Develop         Erect        Demolish          Alter
(Check one)
Name of the owner:    _____________________________________________________
Contact address:      _____________________________________________________
Post code:            _______________________
Telephone no:         _______________________
Name, address and qualification of the engineer, architect or planner involved in the
proposed work:
For planning:                    ____________________________________________
For architectural design:        ____________________________________________
For structural design:           ____________________________________________
For civil works design:          ____________________________________________
For other services design:       ____________________________________________
Address of the site
Plot number: ______________________        Holding number: __________________
Dag/Khatian number: ______________         Mouza/Block/Sector:
Street name: ______________________        Municipal ward number: _______________
Documents enclosed along with this form:
      Name of document            Number of sheets           Number of copies
1.    Key plan                       _____                       _____
2.    Site plan                      _____                       _____
3.    Subdivision/layout plan        _____                       _____
4.    Building plan                  _____                       _____
5.    Services plan                  _____                       _____
6.    Specifications                 _____                       _____
7.    Ownership title                _____                       _____
     _________________                            _____________________________
              Date                                              Signature of the owner

For use of the Building Official. Do not write anything below this line.
Reference number: ___________________________                     Date: ______________
(To be referred to in all subsequent correspondences)
Received by: ______________________________