Form G *

[Rule 32]

Application for Licence for Erection of Wall, Fence, Building etc.

1. Name of applicant and address :
2. Taluk, Village and Survey No. of the land where : the erection of structure is proposed to be made
3. Extent of land :
4. Boundaries ;
5. Nature of erection proposed to be made :
6. Whether temporary or permanent if temporary the duration for which the license is sought
7. If the land is already occupied the month and the : year from which it was occupied
8. Annual income of the applicant : (in figures and words)

Signature of applicant.

Place:
Date:

(Note:- This application should be accompanied by three copies of the plans of the structure proposed to be erected.)

* Inserted by SRO 1403/89 dt. 28-06-1989 pub. in K.G. No. 32 dt. 08-08-1989.