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Technical License Application Form - 21082017020357

This document is an application form for a technical license from the Aizawl Municipal Corporation. It requests the applicant's name, address, contact information, technical qualifications, the type of license being applied for, experience details, and includes an undertaking to abide by building regulations. The applicant must also submit the necessary fees for registration and a security deposit with the completed application form.

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charlie
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43 views

Technical License Application Form - 21082017020357

This document is an application form for a technical license from the Aizawl Municipal Corporation. It requests the applicant's name, address, contact information, technical qualifications, the type of license being applied for, experience details, and includes an undertaking to abide by building regulations. The applicant must also submit the necessary fees for registration and a security deposit with the completed application form.

Uploaded by

charlie
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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AIZAWL MUNICIPAL CORPORATION

Ch. Chhunga Bus Terminal, Thuampui


Aizawl - 796017, Mizoram

FORM OF APPLICATION FOR TECHNICAL LICENSE


[Regulation 5(11)(12(16) & ANNEXURE - ‘B’ of the Aizawl Municipal Council Building Regulations,
2012]

1. Name of Applicant/Firm/Group : ___________________________________


(in capital letter)
S/o, D/o : ___________________________________
2. Address : ___________________________________
___________________________________
Telephone No. : ___________________________________
Mobile No. : ___________________________________

3. Technical Qualification : ___________________________________


(attested copy of Certificate/
Registration should be enclosed) : ___________________________________
4. Line in which License is
applied for (please tick) : Structural Engineer/Engineer/
Architect/Supervisor/Group/Firm
5. Experience (photo copy) of : ___________________________________
works already carried out duly ___________________________________
certified by competent authority. ___________________________________
6. Undertaking : ___________________________________

The necessary fee for Registration amounting to Rs.


___________________ (Rupees __________________________________________) only
and security deposit amounting to Rs. ____________________________________ (Rupees
_________________________________________________) only are enclosed herewith.

Signature :
NAME : _______________________________
Address : _______________________________
Place _________________ _______________________________
Date __________________ _______________________________

[Phone Nos. 0389-2352090/2352091/2352089]


AIZAWL MUNICIPAL CORPORATION
Ch. Chhunga Bus Terminal, Thuampui
Aizawl - 796017, Mizoram

U N D E R T A K I NG

I _________________________________________ a registered licensed


Architect/Structural Engineer/Engineer/Supervisor/Group/Firm, hereby pledge that I will
abide by the AMC Building Regulations, 2012 with specific reference to Regulation 5,
Regulation 11, Regulation 13 and Regulation 16 ANNEXURE - B-1 failing which I would
be liable to get may registration/license cancelled.

Signature :
NAME : _______________________________
Address : _______________________________
_______________________________
Place _________________ _______________________________
Date __________________ _______________________________

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