“APPENDULA, (See Rube 7 (1) and Rule 124(1)] ‘Apptication for Buliding PermityReguiartsationeta of Documents, Plan, Certificates etc; to be subrmttned 1. Qumerthig 2. Land Tax Receipt 3. Ste Plan 4, Location Plan 5. Bulding/ Development Pan DECLARATION | SRLANILKLMAR AND SATT-ASMATHY here by declare thatthe measurements, specification and other Udetaits mentioned above ste corre, aed tte to the Best ot my ‘ad beled, are that | shall abide hy the approved plan snd the pravisians in the Aét and Rules ih undertaking the contruction. Place :ilappucha Date :o1a3/20%8 Signature of the Applicant with Name (CERTIFICATE 1. Certfie thatthe ute plan s prepared after verification of ownership document ite and the ‘nsmarements shou areieund (be comet Serif tha the bung an is perpared in acorn with the praons in te Kea Panchayath building rules. 201, Reval et 1994, and the Provsion Contained inthe sanctioned Towa Planning Schemet/ Sanctioned Master Bann. Signature: Dame 2:SaSIKUMAR Reg. No, :€-4954/15/SA-TE7 KLM ‘Acddress KANNANNOORE HOUSE CCHENNITHALR SOUTH FO MAVELEARA. Registered bechitectiEnginces? Tove Plannes/Supervsar) Place:slappuche Date 10/03/2015 ‘UNDERTAKING UR SASIUMAR bere ny undertake that the building corstruction/Land Development will be cari ‘onibemng carried on/vas carries on ss pes the appsovea plan and permit mm accorgance: wth te es ‘ares, Stenature Mame :K'SASKUMAR Reg. No. :£-1954/15/SA-7ET KLM. ‘Address KAMNARNOORE HOUSE "CHENNITHALA SOUTH PO MAVELIRARA, (Registered Architect/Enginaer? Town Planner/Supervisar) Placealappuchs Date :01/037208 VERIFICATION. SF ete i en Pein prod ely YM Seana s Cates CLT Permit Fee 2. 307.53