APPENDIX- A1

[See rules 5(1)(b), 75(1), 87(1) and 93(1)]

APPLICATION FOR PERMIT/REGULARISATION
Madhur Grama Panchayat , Kasargode

File No: 14511940121001476751 Electoral Ward : Registration No : 1476751

1. Name in capital letters MURALEEDHARAN K.
2. Address:
2(i). Permanent address of the owner 0/, S/O DAYANANDA K., s/o dayananda k., kudlu, shivakrishna road,
KUDLU, 671125
2(ii). To which communications are to S/O DAYANANDA K.,s/o dayananda k.,kudlu,shivakrishna
be sent road,KUDLU,Kasargode,India ,Ramdas Nagar-671125
3. Nature of New Construction
development/Construction
4 Details of Plot
Sl (i)Survey No (ii)Resurvey (iii)Extent In (iv)Nature Of (v)Deed No. (vi)Deed (vii) Sub (viii)
. No Ares Ownership Date Registrar's Sub
N Office Division
o
1 346/7-1 346/7-1 4.05 Gift Deed 3153/1/2021 18/08/2021 Kasaragod Kasarag
od
ix. Ward No. 15
x. Nearest Electric Post/Telecom vdnr004009145
Post number
xi. Taluk Kasaragod
xii. Revenue Village Kudlu
xiii. District Kasargode
5. Whether the land, if any, No
contiguous to this plot of the
owner shown in the site plan (Rule
6(4)(a)(i)): Yes /No
6 Usage of surrounding plots in general
6(i). North Residential plot with without vehicular road access
6(ii). East Residential plot with without vehicular road access
6(iii). South Garden Land with road access
6(iv). West Residential plot with private road access
7. Whether Government or Quasi No
Government
8. Details of the Construction
Mercantile/Commercia
Special Residential

Multiplex Complex
Medical/Hospital

Office/Business

Industrial G1

Industrial G2
Construction

Educational
Residential

Hazardous
AreaType

Assembly

Storage

Total
Floor

1st Ground Floor Building Area 114. 114.

Constructi 12 12
on
1st 1st Floor Building Area 27.6 27.6
Constructi
on
1st Ground Floor Floor Area 114. 114.
Constructi 12 12
on
1st 1st Floor Floor Area 27.6 27.6
Constructi
on

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 8(i). Other Construction Details

Whether Government or Quasi

Permit Fee Area in Sqm

Other Rule Description

Other Rule Comments

Coverage Area in Sqm

Special Condition
Existing Building

Number of Well
FSI Area in Sqm

Existing Area
Construction

Parking Unit
Acess Width

Wall Length

Permit Fee
Govt:
Slno

1 New Construction × 3 0 141.7 114.1 141.7 × 0 0 0 496.02

2 2 2
8(ii). Height of Construction in Meters:
From ground level From Street level From Street level
Construction From ground level without with stair without stair room, with stair room,
stair room,machine room,etc. room,machine machine room, etc machine room, etc
room,etc.
1st
Construction 6.75 6.75 7 7

8(iii). Total Built-up Area 141.72

8(iv). Total Covered Area 114.12
8(v). Total parking area provided inside 0
the building(s)
8(vi). Total Area for F.S.I. 141.72
9. Basic KPBR Verification w.r.t. proposed plot
Sl.No. Rule Description Provided
No.
1. Access width to the plot 0
2. Coverage in % 28.18
3. Floor Space Index 0.35
10. Basic KPBR Verification w.r.t. proposed building(s)

Building Type: Group - A1. Residential building up to 7 mheight for Construction 1.

No Mandatory permissible type as per building rules Requir Provide Remarks of

ed d Verifier
1 (28)Access to the building (in metre) <=0.00 3.00
2 (23)Minimum distance from the abutting road/access to other building(s) (in <=0.00 3.20
metre)
3 (29)No. of Four-wheeler parking <=0.00 0.00
4 (29)No. of Two-wheeler parking <=0.00 0.00
5 (29)No. of Parking for Differently abled <=0.00 0.00
6 (29)No. of Parking for Visitors <=0.00 0.00
7 (29)Loading/unloading space (in sqm) <=0.00 0.00
8 (26)Set Backs (in m) 0.00 YES
9 (26)Front <=3.00 3.80
10 (26)Side 1 <=1.00 1.00
11 (26)Side 2 <=1.00 1.20
12 (26)Rear <=1.50 3.20
13 (37)Exit Width (in m) <=0.00 0.00
14 (35(1))No. of Stair case(s) <=0.00 0.00
15 (35(2))No. of Fire Escape Stair case(s) <=0.00 0.00
16 (76(2)3)Rainwater storage capacity (in litre) 25.00 NA
17 (62)SURRENDERED FOR ROADS 0.00 NA
18 (72)SPECIAL PROVISIONS 0.00 NA
19 (77)Solar Assisted Water Heater/Lighting System 0.00 NA

11. Provisions of Town Planning Schemes, if any, applicable to the construction

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 11(i).Zoning
Sl.No. Name of the TP Stage(Sanctioned/Pub Zone Permissibility of
Scheme lished) proposed construction
as per the scheme
11(ii).Road Widening
Sl.No. Name of the Stage(Sancti Existing Proposed Building Line Set Back Set back
TP Scheme oned/Publish Width of Width of (in m) Required provided (in
ed) road (in m) road (in m) from m)
Existing road
boundary (in
m)
12. Permissibility with respect to NA
Kerala Conservation of Paddy Land
and Wet and Act 2008 / KLU order
1967
12(i). Type of land as per BTR
12(ii). Type of land as per Data Bank
13. If the application is for
regularisation
13(i). Whether construction completed
or not
13(ii). If not completed, the stage of
construction
14. Details of permit/approved plan
already obtained.
Permit No.
Permit Date , ,
15. Details of Fee paid Application fee Layout scrutiny fee
15(i) Amount 0 0
15(ii) No. and date of receipt ,
16. Details of documents, plans, certificate, etc. enclosed
1. Ownership 2. Land Tax Receipt 3. Site Plan 4. Location Plan 5. Building/Development Plan
17. Details of NOC obtained
Sl.No. Required Whether enclosed or not Details of the NOC / Clearances

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 18. DECLARATION
I MURALEEDHARAN K. hereby declare that the measurements, specifications and other details mentioned
above are correct, complete and true to the best of my knowledge and belief and that I shall abide by the
approved plan and the provisions in the Act and Rules in undertaking the construction.
Place :Kasargode
Date :29/09/2021
Signature of the Applicant with Name
19. CERTIFICATE
1. Certified that the site plan is prepared after verification of ownership document and site and the
measurements shown are found to be correct.
2. Certified that the building plan is prepared in accordance with the provisions in the Kerala Panchayat
Building Rules 2019, Kerala Panchayat Raj Act, 1994 and the provisions contained in the sanctioned Town
Planning Schemes, if any.

Signature
Name :SHIVAPRASAD S
Reg.No. :E-2050/08/17434/KKD/42/2020/SA
Address MUDALAPPARA(H), MULIYAR P.O., KASARAGOD: 671542
(Registered Architect/Engineer/ Town Planner/Supervisor)
Place:Kasargode
Date :29/09/2021
20. UNDERTAKING
I SHIVAPRASAD S hereby undertake that the building construction and/or land development will be carried
on/ being carried on/ was carried on as per the approved plan and permit in accordance with the rules in
force.

Signature
Name :SHIVAPRASAD S
Reg.No. :E-2050/08/17434/KKD/42/2020/SA
Address MUDALAPPARA(H), MULIYAR P.O., KASARAGOD: 671542
(Registered Architect/Engineer/ Town Planner/Supervisor)
Place:Kasargode
Date :29/09/2021
21. VERIFICATION
Certified that the extract of the Building Permit Application prepared electronically on 29/09/2021 at
was verified by me in details and to the best of my knowledge and belief the entries made there in are
correct.
22. Permit Fee Rs. 496.02

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