(TO BE COLLECTED ALONG WITH BUILDING PERMISSION FEE)

A.P.I.I.C. Industrial Area Local Authority (I.A.L.A),-Adibatla

Telangana Division
(Constituted u/s 147 of A.P.P.R.Act 1994 and read with G.O Ms.No.285, dated:13.06.2013 for Aerospace & Precision Engineering SEZ,
Adibatla and IT/ITES Special Economic Zone Adibatla, Rangareddy (District) of Panchayat Raj and Rural Development(PTS IV)
Department).

APPLICATION FOR BUILDING PERMISSION TO CONSTRUCT / MAKE ADDITIONS &

ALTERATIONS, EXTENSIONS TO BUILDING (S).

To, Dated: ...

The Executive Officer,
Shamshabad Zone,
Opp: R.S.F.P & D, Srisailam Highway,Phadi Shareef,
Via Keshavagiri, Hyderabad 500 005,
Phone No: ..

Sir,
I/We hereby submit application to construct a Building/make addition/ alterations/
Extension to Building in Plot No._______________ at ADIBATLA in Survey No.______ of
_________________ village _____________ Mandal, ___________ District, in Accordanc
with Section 13 & 14 of the Andhra Pradesh Urban Areas ( Development) Act, 1975. The
details of our proposed Building/ Project are as follows:
1. Name of the Applicant/ Unit :
With address
2. Location (Plot No.. and
Name of Industrial Park) :
3. Utility of the proposed Building/Complex:
4. Plot Area (in Sqm) :
5. Built up Area proposed
Ground Floor (In Sqm) :
UPPER Floor (In Sqm) :
6. Height of the proposed Building (I Mts) :
7. APIIC Allotment Letter :

8. Date of execution of Sale agreement / Lease Deed :

9. Date of taking Possession of land :
10. Details of Extension of Time (E.O.T) granted by APIIC
if the stipulated project implementation period of 2 years
is expired :

(Contd..,2)
 ::2::
11. If purchased from third party
a) Name of the Seller:
b) Date of Sale Deed:
c) Whether Ownership of property: YES/NO
Mutated in IALA records
12. Details of Property Tax Paid, if any: Rs Up to .
(Year) Receipt No: Date: ..
13. Line of activity
a) As per APIIC allotment order:
b) As per SSI Registration Certificate/
Letter of intent:
c) Installed capacity of proposed Machinery (Power) : HP
d) Number of Industrial Workers to be employed: . Nos
14. Setbacks left for proposed building
Front : Mts Stipulated: .. Mts
Rear : ....Mts Stipulated: .. Mts
Left : .... Mts Stipulated: .. Mts
Right : .... Mts Stipulated: .. Mts
Others: .... Mts Stipulated: .. Mts
15. The width of Corridor is Mts.
16. The width of Staricase is . Mts.
17. Whether site is accessible through an existing road: YES/NO
If yes, give details of access: Public/Private Road width of Road:
Mts.

18. Details of initial processing fee (Non- Refundable) in the shape of Demand Draft in
favour of

A.P.I.I.C I.A.L.A, ADIBATLA.

D.D No: Date:

Drawn on: ... Branch:

(Contd..,3)
 ::3::

I/We herewith submit the following documents, building plans & drawings and other
particulars I respect of the proposed Building / Complex duly signed by me, Architect,
Builder and Structural Engineer etc. All plans / drawings shall be in Quadruplicate with one
set of plans on Tracing Cloth.

a) Site/Location Plan drawn to appropriate scale showing the site/ plot to be built upon
with
Surrounding physical features, adjoining/neighboring development, Plot Nos ,/Survey
Nos, access road indicating the width, other existing road network, Water Supply &
Sewerage Disposal Lines, Electricity Lines and other physical features within the
Site/Plot.
b) Building Plans drawn to appropriate scale in metric system clearly indicating all
dimensions, use of each area/ room, wall thickness, columns & beams thickness/
dimensions, of all areas, utility areas, general specifications of materials to be used
instatement form in the drawing.
c) Plan showing the Parking arrangements within the site.
d) Appropriate Elevation & Sections of proposed Building drawn to same scale as at
(b) & giving dimensions in metric system.
e) Plans & Sections of proposed Sewerage disposal system. Water Supply system of
proposed building/ blocks to suitable scale and as per ISI Code and Standards.
f) Copy of previously approved building plan (where required).
g) Built-up area Calculations sheet.
h) Machinery Layout proposed / to be installed duly showing Horse Power of each
machine.
i) Topo plan drawn to appropriate scale showing the development around the proposed
site within a radius of 400.00 mts.
j) Declarations and attested copies of the following.
Ownership document (Sale Agreement / Sale Deed).
No Objection Certificate from Airport Authority of India (A.A.I).
Registration Certificates of Architect, Structural Engineer and Builder.
Soil Test Report indicating the safe Bearing Capacity (S.B.C) of Soil at proposed
site of work.
Declaration and Undertaking by the Owner, Builder, Architect, Structural
Engineer Etc. as applicable.
SSI Registration issued by Industries Department.
Consent for Establishment issued by Andhra Pradesh Pollution Control Board
(A.P.P.C.B).
Detailed Building Plan approved by Inspector of Factories, Factories
Department with Proceedings (in Original).Contractors all risk insurance policy (in
Original).

(Contd.4)

::4::
 Prior approval of Fire Department Permission with approved plans of Proposed
Building and Proof check of Structural designs by third (3 rd) party in case of High Rise
Building (or) any building having Built-up area of 500 Sqm in each Floor.

Note: All plans, Documents and other enclosures to the application shall be signed by the
Owner.

(Contd.5)
 ::5::

NAME AND ADDRESSES OF OWNER/ARCHITECT/STRUCTUAL ENGINEER/

BUILDER

Sl.no Name and Address with Registration Validity Period

phone No. No.
1 Owner

2 Architect/
Engineer

3 Structural T.Raghavendra 39/Strl 31-03-2019

Engineer H.No:1-7-171 .Engineer/
Second floor TP10/GHMC
Bakaram
Musheerabad
Hyderabad
9441449531

4 Builder M/s. Stellar Space Pvt Ltd

The Cuckoos Nest,
Plot No.418, Road No.22,
Jubilee Hills, Hyd-500 033
Ph: 040-23420280
Fax: 040-23420284

(Contd..6)
 ::6::

DECLARATION
I/We declare that I/We are the absolute Owner/Owners/Lessee of the Land/ Plot No:
Adibatla on which I/We intend to erect the Building and am/are
enclosing copies of relevant documents of Ownership/Lease certified by Magistrate/Notary.
I/We have fully gone through the Building rules & Regulations as per G.O Ms. No.86,
M.A., Dated: 03.03.2006, G.O Ms.No.171, M.A., dated: 19.04.2006, G.O Ms.No. 623, M.A.,
Dated: 01.12.2006 of M.A & U.D department, HADA Development Promotion Regulations,
myself/ ourselves that the site and building plans are in accordance with provisions contained
therein.

Yours Faithfully,

Signature of the Owner/Lessee

Countersigned by

Signature of the Architect /Engineer

Registration No.
Contact No.

Signature of the Structural Engineer

License No. 39/Strl .Engineer/TP10/GHMC
Contact No.9441449531

Signature of the Builder STELLAR SPACE PVT LTD

License No.
Contact No. 040 23420280

(Contd..7)
 ::7::

ANNEXURE-A

(TO BE GIVEN BY THE OWNER ON RS.100/- NON-

JUDICIAL STAMP PAPER AND NOTARIZED)
DECLARATION

I/We Resident of . Hereby affirm/declare

1. That I/We are Owners/authorized persons of the Site/Plot no: at ADIBATLA.

2. That the Site/Plot/Property boundaries and dimensions mentioned in the Site Plan/ Building
Drawings are correct & true.
3. That to pay all the necessary fees and Charges livable by APIIC-IALA-ADIBATLA Under
the Andhra Pradesh Urban Areas (Development) Act, 1975.
4. That I/We are aware that specific development conditions may be imposed by APIIC-IALA-
ADIBATLA while approving Building Permission Under Section 14 of the Andhra Pradesh
Urban (Development) Act, 1975 AND I/We assure to comply with the same.
5. That I/We undertake to supervise the construction in accordance with the approved building
drawing with reference to the Zoning Regulations/Master Plan and the building
rules/stipulations and the conditions contained in the Building Permission.
6. That I/We shall be ensure Structural Safety and Fire safety of the buildings as per the
National Building Code and Bureau of India Standards, relevant Act and Rules.
7. That I/We shall be responsible for ensuring the proposed building(s) construction shall
confirm to the Building Permission accorded, and that all building services shall confirm to
the National Building Cod and Bureau of Indian standards.
8. That, the structural designs and drawings prepared duly taking the Safe Bearing Capacity
(S.B.C) into consideration.
9. That I/We shall be responsible and liable for action by the Competent authority/ Government
in case of any violations, deviations o th4 sanctioned plan and any Structural failure,
deficiency in Fire Safety measures, deficiency in Building services, etc.,
10. That I/We authorized the Competent Authority to summarily demolish any deviations or
violations at any time noticed in the proposed construction and make good the loss and
recover the cost of the same from me/us.
11. That I/We hereby hand over Ground Floor Area/First Floor/Second Floor _____________
Sqmts/ ________ Sqft to the Manager (AM) and Executive Office, A.P.I.I.C-I.A.L.A-
ADIBATLA as per the rules and regulations issued vide G.O Ms No.86, dated: 03.03.2006,
G.O Ms No. 171 dated: 19.04.2006 and G.O Ms. No.623, dated: 01.12.2006 of the M.A &
U.D Department.

Place:
Dated: Signature(s) of Owner(s)
Name of the Company:
Address:
(Contd..8)
 ::8::

ANNEXURE-B

(Notarized undertaking to be executed by the

Owner on Rs.100/- Non- Judicial Stamp Paper)
UNDER TAKING
This undertaking is executed on this day i.e of .by R/o..
situated at herein after called the 1 st party which term shall include their Legal
heirs, successors, agents, assignees and tenants in favour of Executive Officer, A.P.I.I.C- I.A.L.A-
ADIBATLA, hereinafter called the 2nd partry which term shall include their representatives, agents,
officials, staff of A.P.I.I.C-I.A.L.A-ADIBATLA.

Whereas, the 1st party has applied for permission for the construction of Building in Plot No
. Situated at ADIBARLA whereas, the 2nd party imposed the following conditions for
granting the Building Permission.

A) PARKING SPACE: The Parking Space is provide in the Building Cellar/Stilt floor for
parking of vehicles and it should not be converted (or) misused for any other purpose
other than parking of vehicles and it should be free all cross walls/partition walls, and
rolling shutters and the 2nd party is at liberty to demolish (or) remove the same without
any notice in case, if the 1st party violates the undertaking executed.
B) BALCONY PROJECTIONS: The Balconies shall not be enclosed by converting them
as toilets/ bathrooms or including into rooms by reducing the mandatory open spaces and
if any such construction is made, the same would be removed by 2 nd party without giving
any notices.
C) PAYMENT OF SPECIAL COLLECTION CHARGES FOR GARBAGE: That the 1st
party should pay special collection charges for garbage disposal as prescribed for
garbage refuse collection.
D) PAYMENT OF SPECIAL SANITATION FEE: That the 1st party should pay special
sanitation fee for the routine clearing and desalting of Storm Water Drain.
E) STOCKING OF BUILDING MATERIAL AND DUMPING OF DEBRIS: That the 1st
party should not stock the building material and dump any debris on the road
marking/footpaths or on A.P.I.I.C- I.A.L.A-ADIBATLA or Government land.
F) NO.OF UNITS: The number of units permitted should not be increased and the building
should not be converted into Group Housing and sold at any time in future.
G) PERCOLATION PITS AND TERRACE WATER COLLECTION: The paved space
around the Building shall be provide with percolation pits of 4 x 4 x4 covering at least
30% of such area and provide terrace water collection and open ground as per Para 16(b)
& (c) of G.O. Ms. No.423, M.A., dated:31.07.1998, G.O.Ms.No.538 M.A & U.D, dated:
29.10.2001.

(Contd.9)
 ::9::

THE 1ST OPARTY IN TOKEN OF ACCEPTING THE ABOVE CONDITIONS

IMPOSED BY THE 2ND PARTY HEREBY UNDERTAKES THAT:

a) The parking Space provide in the Stilt/Cellar for parking of vehicles in the Factory
Building/Complex will not be converted (or) misused for any other purpose other than
parking of vehicles and it will be free from any partition walls/cross walls and rolling
shutters will not be provided at any time in future and the 2 nd party is at liberty to
demolish (or) remove the same if provided without any notice.

b) That the Balconies will not be converted into Toilets, Bath and Water Closets,
Staircase, Landing or Convert into rooms etc., and if any such construction is ade, the
2nd party is at liberty remove them without any notices.

c) That I/We or purchaser of the Factory Building/ Complex etc. will pays the special
collection charges for the garbage disposal as prescribed for garbage refuse
collection on demand from 2nd party.

d) That I/We or purchaser of the Factory Building / Complex etc. will pays the special
sanitation fees for the routine clearing, desilting of Storm Water Drain on demand
from 2nd party.

e) That I/We will not should not stock the building material and do not dump debris
on the road marking/ footpaths or on A.P.I.I.C- I.A.L.ADIBATLA or Government
land and the 2nd party is at liberty to remove the same at over cost.

The 1st party in taken of accepting the above conditions imposed by the 2nd party here
by undertakes and assures that all the above conditions will be strictly adhered to, and if
the 1st party commits violation of any of the above conditions, the 2nd party is at liberty to
take action deemed fit.

We the above named deponent do hereby solemnly affirm and certify that we have
voluntarily executed, this under taking with free will and signed this .day of
in presence of the following witness.

Witness: Parties of 1st part

1) 1)

2) 2)

(Contd..10)
 ::10::
(Notarised under taking to be executed on
Rs.100/- Non Judicial Stamp Paper)

UNDERTAKING-(d1)

This undertaking is executed on this ____________________ day of __________ at

Hyderabad, Andhra Pradesh, India, Jointly by:
1. OWNER:
Sri/Smt._________________________ S/o,W/o,D/o___________________
aged______Occupation________________________R/o P.No.__________________
Locality____________________________
2. BUILDER:
(In case if it is entrusted to builder)
Name of the Builder M/s. Stellar Space Pvt Ltd
Address The Cuckoos Nest, Plot No.418,
Road No.22, Jubilee Hills, Hyderabad 500 033
Ph: 040- 23420280
3. ARCHITECT:
Name of the Architect _______________________________
MCH Reg.No _______________________________
Address _______________________________
4. STRUCTURAL ENGINEER:

Name of the Structural Engineer __ T.Raghavendra______________________________

MCH Reg.No __39/Strl .Engineer/TP10/GHMC
Address ________________________________

Here in after called the parties of the 1 st part, which terms shall include their legal heirs
successors, Agents, assignees etc.
In favour of the Executive Officer, APIIC- IALA- ADIBATLA, here in after called the 2nd
party, which terms shall include, their representatives, agents, officers and staff of the APIIC-IALA,
ADIBATLA,.
Where as the persons 1 & 2 being parties of the 1 st party have applied for the building
permission for the proposed construction of Factory Building/Complex consisting of ______ Nos of
Floors at Plot No. ____________________ situated at ADIBATLA,.
In accordance with the provision of G.O Ms No. 86, dated: 03.03.2006, G.O Ms No. 171
dated: 19.04.2006 and G.O Ms No. 623 dated: 01.12.2006 of the M.A & U.D Department.
Whereas the 2nd party imposed the following conditions for the building permission:

I. That the 1st party shall employ a site Engineer, who shall maintain a register in which, the site,
Engineer, Architect and structural Engineer shall record their comments at regular intervals
i.e., at foundation level, and at each roof, slab level, and submit the periodical report to the 2 nd
Party.
II. That the construction work shall strictly be proceeded with under the supervision of the
Architect, Structural Engineer and Site Engineer, without it shall be treated as construction
without permission.
(Contd11)
 ::11::

III. That in case Site Engineer/Structural Engineer/Architect is changed during the course of
Construction or the Architect/Structural Engineer/Site Engineer disassociates themselves with
on going project, the fact shall immediately be reported to the 2nd party i.e., with in seven
days of by registered post/In person along with consent of newly engaged Site
Engineer/Architect/Structural Engineer.

IV. That all the parties of the 1st party viz., Owner, Builder, Architect, Structural Engineer and
Site Engineer shall joi9ntly and severely be held responsible for the structural stability during
the building construction.

That 1st party in token of accepting the above conditions imposed by the 2nd party here
by undertakes and assures that all the above conditions will be strictly adhered too, and if the
1st party commits violation of any of the above conditions, the 2nd party is at liberty to take
action deemed for.

We the above named deponent do hereby solemnly affirm and certify that we have
voluntarily executed, this under taking with free will and signed this _____________day of
____________ in presence of the following witness.

Witness: Parties of 1st Part:

1. 1.

2. 2.

3.

4.

(Contd.12)
 ::12::
(Notarised under taking to be executed On
Rs.100/- Non Judical Stamp Paper)

This undertaking is executed on this _________________ day of _____________ at

Hyderabad, Andhra Pradesh, India, Jointly by:
1. OWNER:
Sri / Smt. _____________________ S/o, W/o, D/o ________________ aged ___________
Occupation ___________________ R/o __________ Plot.No _____________Locality
__________
2.BUILDER:
(In case if it is entrusted to builder)
Name of the Builder M/s. Stellar Space Pvt Ltd
Address The Cuckoos Nest, Plot No.418,
Road No.22, Jubilee Hills, Hyderabad 500 033
Ph: 040- 23420280
Registration No

Here in after called the parties of the 1 st part, which terms shall include their legal heirs
successors, Agents, assignees etc. In favour of the Executive Officer, APIIC- IALA-
ADIBATLA, here in after called the 2nd party, which terms shall include, their representatives,
agents, officers and staff of the APIIC-IALA-ADIBATLA.

Where as the parties of the 1 st party have applied for the building permission for the
proposed construction of Factory Building/Complex consisting of _________ Floors at Plot No.
___________ situated at ADIBATLA, in accordance with the rules and regulations as per G.O
Ms No.86, dated: 03.03.2006, G.O Ms No.171 dated: 19.04.2006 and G.O Ms No. 623, dated:
01.12.2006 of the M.A & U.D Department.

Where as the 2nd party imposed the following conditions for grant of the building
permission:
That the 1st party shall not deliver the possession of any part of built up area of the above
said building proposed to be constructed at the above site by way of sale/ lease, unless and until
the Occupancy certificates obtained from the 2nd party.

We will not deliver the possession of the any part of the built up area of the Proposed
Building to be Constructed by us at the above site by way of sale/ lease unless and until the
Occupancy certificate is obtained by us from this 2nd party by submitting the following:

1. Building Completion Certificate issued by the Architect duly certifying that the
building is completed as per the Sanctioned Plan.
2. Structural Stability Certificate issued by the Structural Engineer duly certifying
that the building is structurally safe and the construction is in accordance with the
specific designs.
3. An extract of the site registers containing inspection reports of Site Engineer,
Structural Engineer and Architect.

(Contd.13)

::13::
 4. Insurance Policy for the Completed building for a minimum period of three
years.

We the above named deponents do herby solemnly affairs and certify that we have voluntarily
executed, this undertaking with free will signed on this _____________ day ___________________
in presence of the following witness.

Witness: Parties of 1st part:

1. 1.

2. 2.

(Contd.14)

::14::
(To be executed on Rs.100/- Non Judicial
Stamp Paper if work is carried out by Owner himself)

Declaration cum Undertakin-(f1)

I/We ___________________________, S/o, D/o, w/o,__________________ aged

______________________, Occupation _________________________, R/o __________
______________ do hereby declare and solemnly affirm as follows.
 That I / We are the owners of the site Plot No. ___________________ Situated at
_____ ___________________ (Mandal), __________________ District admeasuring
__________________Sq.Mtrs and that We have applied for the building permission for
construction of Factory Building/Complex at the above said premises / Site.

That I am / we are taking up the construction of the said building by myself /

ourselves and that I am / we are not entrusting the work to any builder or any other person.

I / We herby under take that I am / we are solely responsible for execution of the
building constructions work accordingly to plan sanctioned by A.P.I.I.C-I.A.L.A,
ADIBATLA, under the strict supervision of the Architect, Structural Engineer, and Site
Engineer engaged by me / ourselves for the purpose.

Hence this Declaration cum- Undertaking.

In witness therefore, I / We execute this on this the _____________________ day of

________________________

Witnesses: Deponent

1. 1. Builder

2.

(Contd..15)
 ::15::
(To be executed on Rs.100/- Non Judicial Stam Paper
if work is entrusted to Builder)
Declaration cum Undertaking (g1)
I / We ______________________ S/o, D/o, W/o __________________________
aged_________,Occupation______________________R/o.______________________ do herby
declare and solemnly affirm as follows:
ADIBATLA, in Sy. No. ______________ of _________ Village of __________________
(Mandal) Mahaboobnagar District admeasuring ________________ Sq.Mtrs. and that we have
applied for the building permission for construction of Factory Building/Complex at the above
said premises/ site.

That I / We have entrusted the Construction of the said building to _________________

Builder /
Construction firm, the details of which are as given below:

Name of the Builder M/s. Stellar Space Pvt Ltd

Construction Firm _________________________________
Represented by Mr. C.J. Surendar / Y Kumar S
Present Address The Cuckoos Nest, Plot No.418,
Road No.22, Jubilee Hills, Hyderabad 500 033
Ph: 040- 23420280
Permanent Address Same as Above
Regd. No. if any

That I am / We are also jointly and severely responsible along with Builders, Architect,
Structural and Site Engineer, for the execution of building according to sanctioned plan.

DEPONENT

(Owner)

I/We being individual/firm/Company/Society/represented by ___________________ as

__________________ address ________________ have been entrusted to construct the building
consisting of _________________ floors for _________________ purpose In Plot. No
___________
Situated at ADIBATLA, by the owners Sri/ Smt. ___________________ , on
__________________ by virtue of a Regtd. Development Agreement (copy of which is enclosed
herewith.)
We hereby undertake to carryout and complete the construction strictly according to the plan
sanctioned by A.P.I.I.C- I.A.L.A, ADIBATLA,

We are jointly responsible for the execution of building accordingly to sanctioned plan along
with owners and Architect, Structural Engineer & Site Engineer engaged by us for the purpose of
supervision.

(Contd16)
 ::16::

I /We fully aware of all the rules and regulations as per G.O Ms No.86, dated:
03.03.2006, G.O Ms No. 171 dated: 19.04.2006 and G.O Ms No. 623 dated: 01.12.2006
of the M.A & U.D Department.
Hence the declaration cum under taking.

In witness therefore, I/We execute this the _______________ day of ________________

1. Builder
Deponent

CHECK LIST TO BE FURNISHED ALONG WITH APPLICVATION SEEKING BUILDING PERMISSION (To be
submitted in duplicate- one to be retained in file and another to be given to applicant as
acknowledgement)

Name of the applicant :

Plot No :
Address :

Contact No :
List of Documents to be enclosed along with the application Submitted
1 Whether Application form is filled in full without leaving any blanks and signed by Owner, YES NO
Architect, Structural Engineer etc. besides by the Owner on all the enclosures and plans.

2 Initial Processing Fee Rs.10,000, 00 in favour of A.P.I.I.C I.A.L.A-.ADIBATLA PAID NOT

PAID

3 Building Plans viz Site/Key Plan, Parking and Floor Plans, Sections, Elevations, etc signed by the YES NO
Owner, Architect, Structural Engineer etc.,
A 1 Set of Tracing Cloth YES NO

B 4 Sets of Blue/Ammonia Prints YES NO

4 Copy of Ownership Document(Sale Agreement/ Sale Deed) YES NO
5 No Objection Certificate issued by Airport Authority of India (A.A.I) YES NO
6 Registration Certificates of Architect, Structural Engineer, Builder YES NO
7 Soil Test Report issued by Competent Authority YES NO
8 Declaration and Undertaking (Annexure A & B) by Owner on Rs.100/- Non Judicial Stamp Paper YES NO
and Notarized
9 Other Undertakings by Owner, Architect, Structural Engineer, Builder etc. on Rs.100/- Non YES NO
judicial Stamp Paper and Notarized
10 SSI Registration issued by Industries Department YES NO
11 Consent for Establishment issued by A.P.P.C.B YES No
12 Detailed Building Plan approved by Inspector of Factories, Factories Department YES NO
13 Copy of Building Plans approved earlier (wherever required) YES NO
 14 Copy of Property Tax payment receipt (wherever required) YES NO
15 Copy of Mutation Order approved earlier (wherever required) YES NO
16 Built- up area calculations sheet signed by the Architect and Owner. YES NO
17 In case of High Rise Building or Building with built-up area of 500 Sqm and above

a) Prior approval of Fire Department Permission (Wherever required) YES NO

rd
b) Proof check of Structural Designs by third (3 Party) YES NO

ACKNOWLEDGEMENT
Received the application and documents as stated above

SIGNATURE OF THE RECEIVER

DESIGNATION

------..<><><><>-------
CHECK LIST TO BE FURNISHED ALONG WITH APPLICVATION SEEKING BUILDING PERMISSION (To be
submitted in duplicate- one to be retained in file and another to be given to applicant as
acknowledgement)

Name of the applicant :

Plot No :
Address :

Contact No :
List of Documents to be enclosed along with the application Submitted
1 Whether Application form is filled in full without leaving any blanks and signed by Owner, YES NO
Architect, Structural Engineer etc. besides by the Owner on all the enclosures and plans.

2 Initial Processing Fee Rs.10,000, 00 in favour of A.P.I.I.C I.A.L.A-.ADIBATLA PAID NOT

PAID

3 Building Plans viz Site/Key Plan, Parking and Floor Plans, Sections, Elevations, etc signed by the YES NO
Owner, Architect, Structural Engineer etc.,
A 1 Set of Tracing Cloth YES NO

B 4 Sets of Blue/Ammonia Prints YES NO

4 Copy of Ownership Document(Sale Agreement/ Sale Deed) YES NO
5 No Objection Certificate issued by Airport Authority of India (A.A.I) YES NO
6 Registration Certificates of Architect, Structural Engineer, Builder YES NO
7 Soil Test Report issued by Competent Authority YES NO
8 Declaration and Undertaking (Annexure A & B) by Owner on Rs.100/- Non Judicial Stamp Paper YES NO
and Notarized
9 Other Undertakings by Owner, Architect, Structural Engineer, Builder etc. on Rs.100/- Non YES NO
judicial Stamp Paper and Notarized
10 SSI Registration issued by Industries Department YES NO
11 Consent for Establishment issued by A.P.P.C.B YES No
12 Detailed Building Plan approved by Inspector of Factories, Factories Department YES NO
13 Copy of Building Plans approved earlier (wherever required) YES NO
14 Copy of Property Tax payment receipt (wherever required) YES NO
15 Copy of Mutation Order approved earlier (wherever required) YES NO
16 Built- up area calculations sheet signed by the Architect and Owner. YES NO
17 In case of High Rise Building or Building with built-up area of 500 Sqm and above

a) Prior approval of Fire Department Permission (Wherever required) YES NO

b) Proof check of Structural Designs by third (3rd Party) YES NO
ACKNOWLEDGEMENT
Received the application and documents as stated above

SIGNATURE OF THE RECEIVER

DESIGNATION

------..<><><><>-------