FORM – A

[See Guideline 3(1)]

Application for exemption of Buildings under section 113-C of the
Tamil Nadu Town and Country Planning Act, 1971 (Tamil Nadu Act
35 of 1972)
From
To
The …………………………
Sir,
I hereby apply for exemption of Buildings under section 113-C of the
Tamil Nadu Town and Country Planning Act, 1971 (Tamil Nadu Act 35 of
1972) and Planning permission for the following development:-
I have put up the building in land in S.No. --------------,Block No.----------
of Revenue Division No.------------ for ------------------ purposes.
The site is in the -----------------------------layout approved by/not in any
approved layout. in No. ___________________________________
dated ___________________________
I forward herewith the following particulars:
(a) Five copies of plans showing the construction as per site conditions
including its usage, duly signed by both the applicant who has the
right over the land to develop and the Architect / Engineer / Licensed
Surveyor and other professionals as prescribed by the local authority
concerned in their Act / Building rules;
(b) A copy of ownership document duly attested by a Notary Public;
(c) A copy of the approved plan, duly attested by an Architect /Engineer
/ Licensed Surveyor and other professionals as prescribed by the
local authority concerned in their Act / Building rules, if there is an
earlier approval for existing developments within the plot;
(d) A copy of patta with FMB sketch or permanent land register (PLR)
extract duly attested by an officer not lower in the rank of the Deputy
Tahsildar;
(e) A copy of property tax work sheet indicating the number of floors
and built-up area of the building which was inexistence on or before
1st July, 2007 duly attested by the competent authority of the local
authority;
(f) A certificate from the local authority about adequacy of measures
taken for lighting and ventilations;
(g) A certificate issued by the Director of Fire safety and rescue services,
about the adequacy of fire safety measures taken to the satisfaction
of the Fire safety and rescue services department;
(h) A certificate from a qualified structural engineer about whether the
structure is sound and safe;
(i) A clearance certificate from the Tamil Nadu Pollution Control Board in
case of any industrial development including cottage industry;
(j) A demand draft or Banker’s cheque towards scrutiny fee at the rate
of Rs.4.50 per square metre for total floor area of buildings within the
site drawn in favour of the Commissioner of Town
and Country Planning, Chennai, payable at Chennai;
(k) A Declaration of violated road width, setback spaces and floor area
category-wise and self assessment of the amount for exemption
payable with detailed working sheets duly signed by both the
applicant and an Architect / Engineer / Licensed Surveyor and other
professionals as prescribed by the local authority concerned in their
Act / Building rules;
(l) A demand draft or Banker’s cheque as payment in advance towards
self-assessed amount for exemption drawn in favour of the Commissioner of
Town and Country Planning, Chennai, payable at Chennai.
(m) A notarised undertaking in a non-judicial stamp paper of value not
less than Rs.20/- agreeing to remit the balance amount for
exemption, if any, as assessed by the competent authority after
adjusting the advance payment made, and also all other fees and
charges normally leviable for planning and building permission, from
time to time, by the competent authority;
I, the owner / legal representative of every part of the land to which the
accompanying application relates request the Planning Permission for the
development may be accorded.
Date :
Signature of the Owner of the land and building or Applicant.
* Strike out the portions which are not applicable.
ANNEXURE
To be Completed by the applicant:-
1. Applicant Name (in block capitals)
Address
Telephone No.
2. Particulars or proposal for which
permission of approval is sought.
(a) Full address or location of the land to
which this application relates and site
area.
Door / Plot No.
Town Survey No. / Survey Field No.
Division or / Ward No.
Road or Street Name
Name of Local Authority
Site area
(b) Particulars of proposed development
including the purposes for which the
land and / or buildings are to be
used.
(c) State whether applicant owns or
controls any adjoining land and if so
give its location and extent.
(d) State whether the proposal involves.
i) New building(s)
ii) Alteration, extension or addition
iii) Change of use
3. Particulars of present and previous use
of buildings or land
(i) Present use of building / land
Extent in Sq. Mts.
(1) (2)
Building Land
(ii) If vacant, the last previous use Extent in Square
meters
4. Information regarding the proposed use.
(a) Total floor area of all building to
which the application relates
(b) Residential floor space
(c) Floor space for retail / wholesale
trading
(d) Office floor space
(e) Industrial floor space
(f) Floor space for other use (to be
specified)
5. What provisions have been made for
parking, loading and unloading of
vehicles with the contrilage of the site?
(Please show the location of such
provisions on the plans)
6. Does the proposed development involve
the felling of any tree?
7. If yes, Indicate the position on plan.
8. Does the proposed development involve
the Erection of any advertisement
board?
9. If yes, indicate its position on plan and
type of the advertisement board to be
erected.
Signature of the Owner of the land and
building or Applicant.
Signature of Licensed Surveyor.
Note : Those applying only to find out whether the type of development
is permissible or not, may furnish information against 1, 2, 3 (i) only.
CONDITIONS
i) I agree not to proceed with the development until the planning
permission is granted by the Authority under section 48 of the Tamil Nadu
Town and Country Planning Act, 1971 (Tamil Nadu Act 35 of 1972) as
amended in Act 22 of 1974.
ii) I agree not to do any development otherwise than in accordance with
the site and building plans which have been approved or contravention of
any provisions of the Tamil Nadu Town and Country Planning Act, 1971
(Tamil Nadu Act 35 of 1972) as amended in Act 22 of 1974 or any rule,
‘byelaws’ order or other declaration made thereunder or of any direction
or requisition lawfully given or made under the said act, rules or byelaws.
iii) Under Section 54 of the Tamil Nadu Town and Country Planning Act,
1971 (Tamil Nadu Act 35 of 1972) as amended in Act 22 of 1974, I agree
to make any modifications which may be required by any notice issued by
any order confirmed by the Authority.
iv) I agree to keep one of the approved site plan and one set of copies of
the sanctioned plans of the building at the site of the building at all time
when the development is in progress and also agree to see that such
plans are available and the building is open at all reasonable times for the
inspection of the Member - Secretary or any officer authorised by him in
that behalf.
v) I agree to furnish a set of completion plans within fifteen days from the
date of completion of the development.
Signature of the Owner of the land and
building or Applicant.