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Revised Plan Approval Application Form

The document is an application form for revised plan approval for a factory. It requests applicant and factory details like contact information, production information, and raw materials used. It also requests informant details and required document attachments.

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venu manikanta
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30 views

Revised Plan Approval Application Form

The document is an application form for revised plan approval for a factory. It requests applicant and factory details like contact information, production information, and raw materials used. It also requests informant details and required document attachments.

Uploaded by

venu manikanta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Revised Plan Approval Application Form

Applicant Details:-
Aadhaar Card No: _________________ Applicant Name*: _____________________________
Father/Husband Name*: ____________________________ Gender *: ____________________
District*: ________________Mandal*: ________________Village / Ward *: _______________
Door No: ____________Locality/Land Mark: ______________________Pin Code: ___________
Mobile No*: ______________ Email Id: ______________________Pan card No*: __________

Factory Details:-

Name of the Factory: *: _____________________________ Door Number: ________________


District *: _______________Mandal *: _________________Village/Ward*:________________
Locality/Land Mark*:_________________________________ Pin Code*:__________________
Mobile No*:___________________________ Registration No*:  Yes  No
If yes: ________________________Email Id: _______________________________________

Service Specific Details:-

Horse Power *:____________________________ (Less than 500, 500 to 1000 Above 1000
Hazards) (Give full details with Horse power of prime mover or Motors)
Nature of Enterprise*:  Small  Medium  Micro
Number of Workers*:
Men: _____________ Women: ____________________
Final products and their output*: _________________________________________________
Raw Material used in the Manufacturing process*:____________________________________
Brief description of manufacturing process*: _________________________________________
Type and nature of wastes and effluents, their quantities and the methods of their disposal*:
_________________________________________________________________________
In case of extensions or additional installations, reference numbers of plans approved earlier*:
_____________________________________________________________________________
Land Survey No*: ________________________

Informant Details:-
Authorized Name*: _____________________________ Authorized Relation*: ___________________
Email Id: _________________ Delivery Type*:  Manual  Local  Non-Local
Mobile NO*:_____________________

Document List:-
Application Form*:
 Pan card of Organization/Aadhaar Card of the Occupier
 Copy of registered sale deed/copy of registered lease deed in case of extensions to the*

Applicant’s Signature

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