Kurnool Municipal Corporation

TOWN PLANNING SECTION

BUILDING APPLICATION FORM

BA No.: 1016/1200/B/KURLIGN-2/2024 Date of submission:08 December, 2024

Sub: Building Application for grant of permission for Construction of Building Permission Notice uls 209 &227 of APM
Act, 1965 /428 & 433 of HMC Act. 1955.

A ADDRESS OF THE APPLICANT

Name (In Full) PARNAPALLI HARITHA
2 Firm Name

3Door No./Flat No. 87/1109-p-19,4th Class Employees Colony, Revenue Ward No 87, Kurnool
4 Road/Street SRI SAIVAIBHAV NAGAR
5 Locality / Mandal NA

6 City |Kurnool PIN 5 1 8 0 0 2

7 District |KURNOOL
8 Phone / Mobile No. 9966430539
9E-mail |[email protected]
B LOCATION OF THE PROPOSED SITE
1 Ward No. Block No. NA
LRS Location Sri SaiVaibhav nagar
3 LRS No. NA
4 RS/ TS No. |702/4
5 Plot No. |19
6Premises No./Door No. 87/1109-p-19
7 Road/Street SRI SAI VAIBHAV NAGAR
8 Locality Ganesh nagar-2
9City/ Town District |Kurnool Kurnool
C DETAILS OF BUILDER / LICENSED PERSONNEL
Name Address License No. Validity
1 Hemanth Kumar Jutla h/no-5-2,. pyalakurthy, kodumur(m). |00124/KUDA2021
(Engineer) Kunool(dt).
2
D DETAILS OF PROPOSED CONSTRUCTION
Site Area (sg. mtr.) As per Documents 145.26
1
As on Ground 145.26
2 Total Floor Area (sq. mtr.) 168.96
3 Tot-lot Area (sq. mtr.) 00.00
4 No. Of Units 2

E DETAILS OF BUILDING
No. of Blocks 1 Total Built-up Area (sq. mtr.) 84.48
 Bifurcation of Floors
HeightNo, of Floors
Use Sub Use Type (mtr.)
Building Name Floor BUA
6.6| Floor Name (sq. mtr,)
Individual NA
1 P HARITHA (PLOT Residential
Residential
19) lGROUND 84.48
Building
FLOOR
FIRST 84.48|
FLOOR

F AUTOCAD FILE
1 AutoCAD File |31 x 51.dwg
APPLICATION CHECKLIST
Remarks
Yes/No
Description
No
1. Is CLUis applicable?
number? No
2 Whether proposed site has VLTIAssessment
building? No
3. |Whether proposed construction is an Educational
Constructed Without No
4 Whether The Proposed Building Is Already
|Approval But Satisfying Present Rules
(Indian Green No
5 Whether the building is pre-certified from IGBC following the G.
BuildingCouncil) or LEED India or TERI or GRIHA
Dated: 28.01.2014 to avail incentives under rule 145.
O. Ms. No. 30
No
6 Whether the proposal falls in Ubanisable Land use zone?
No
7 Whether ECBC is complied for commercial buildings or other
Non-Residential Buildings proposals having plot area more than
Meters or if the
1000 Square Meters or built up area of 2000 Square
Convention Cernter
building is a Multiplexes, Hospitals, Hotels,and
with irrespective of built up area.? No
NMA?
8. Do you want to apply NOCfrom
construction No
9 Whether NMA NOC is available with you for proposed
sites?. No
10. Do you want to apply NOC from AAI?
No
have NOC from AAI?
11 If youare in Airport vicinity, Do you
site? Yes
12. Whether any Approved Plan given in proposed
part of LRS No
13. Whether site falls under Approved LayouVLRS/Plot
|Layout but not regularized ?
of total No
14. Whether 10% of EWS/LIG on the project site or 25% the project site
number of units providedwithin a radius of 5km from
in Group Housing/Development projects? No
proposed
15. Whether Environmental Clearance is required for
bulding?
Agiculture Land No
16. Whether the Land is converted Agnculture to Non-
as per NALA act 20162
penalization scheme No
17. Whether the propOsalcomes under Building
case?
No
18 Is water connection available?
layout and any building No
19. Whether the site falls under un-approved
1985 on this
plan approval is given or any building exist pnor to
site?
/ Gas pipe No
20. Whether Proposed site is located in the vicinity of Oil
line?
distance No
21 Whether edge of the proposed buiding is within 30 mts
from the raiway property bouncary?
50m wthin the limts of the Local Authoites. The boundary of the
No
rive sha" be as fxec and cerufied by the Irigation Department and
Revenue Decatment?
Wheher he proposed sste s iocated within the distance of above No
*Om an upto 200m trom the protected Monuments as notified
 under Archaeological monuments and
24. Whether the proposed site is located in Ancient sites?
the vicinity of defense No
establishments within the distance of 500 mtr?
25. Whether the proposed site falls under Un
approved Layout in which No
building approval given?
26. Whether the plot is affected by road
widening? No
27. Whether the height of the industrial building is greater than 10 No
mtr?
28. |Whether the height of the building is greater than 18 mtr? No
29. Whether the height of the industrial building is greater than 18 mtr.? No
30. Whether the buildings of Educational, Cinema Theatres, Functional N
halls &other Assembly buildings where plot area is greater than 500
5q.m or height is greater than Gm?
31. Whether the Commercial building height is greater than 15 mtrn N

32. Whether the size of the plot is above 200.00 sqmt. with height N
above 10m (Onty for Municipal Corporations)
33. Whether the size of the plot is above 200 sq. mts(Only for No
Municipal Corporations)
H DOCUMENT CHECKUST
Prhmery
Name of the Document Attachment
1. Photographs showing ecGoess roads.
2. Lotest Encumbrance Certficate issued by Registrabion Department.
3.Mester pian/LUP extrect indicetang the ste
4 Selt- Attested copies o Ownership Documents-iease-deed/sale deed etc. giving the
physica description of thepiot/property
A Deciaration cum undertaking and Indemnty bord by the
Owner/Buider/Deveioper/LTP in the prescYed Form (Annexure-3)
6. |Sign Drawing Plan Por And Aptlcetion Form Or Oaer

7 Sign Drewing Ren Par And Aptiication Form Of LIP

8. Selt-Atested Copies of Lank Documets

Adddonal
Nme of he Documet Attachment
Previous Sanctiored Pien copy with detaus of approval for e existng buiding f
amy
whch the work is proposed and that the statement made in
hereby declare that Iam the oaner/ PAH n possession of the piot on
knoatedge
this fhorn are true and correct to the thest af my

ISIGAATURE
Sgnature of te Appcant OrFm PARNAPAWHARITHA Y PHaha
2 w e of the LTP Memanth Kumar Jutia (Engineer) TaratLuny
J. HEMANTH KUMAR
B.Tc ch (C)
KUDA LICE:SED ENG'NE
Lic No: LTP 00124/KUDA 2021
Cell: 99C64 30539