Office of Municipal Corporation, Yamuna Nagar-Jagadhri REPORT. S.No. Details Comments/ Verification 1. Name & Address of Applicant:

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Office of Municipal Corporation, Yamuna Nagar-Jagadhri REPORT Page No. 1 Building Application No. Dated of Receipt Signature of Receiving Clerk with Date S.No. Details Comments/ Verification 1. Name & Address of Applicant: I verify & attest to the correctness of these graphics 2. Photograph of Site Front View and Side view attached on Page No Google Map photo showing. the proposed location on pageno 3. Detail of the proposed construction New Const. Re-Const. Extension Change 4. Category of Proposed const. Residential Commercial Industrial Public others 5. Category of the area / colony as per zoning plan Residential Commercial Industrial Public others 6. Address of site of Proposed const 7. Ownership proof of site of proposed const. pasted at page no. 8. Name of the Architect Registration No./ Renewal License No. Sr. No. in M.C. List App. Signature B.I. Signature 9. Total area of the site as per ownership proof. 10. Total Area of site of present building application 11. Report about proposed structure being Anti-seismic structure, installation of fire safety equipments, rain harvesting system and solar energy & certification on application about solar energy system (Yes/ No) 12. Provision of Dual Flush Button (Yes / No) 13. Provision of letter box on ground floor (Yes/ No) Architect Signature & Seal 14. i. Regular (Authorised area) Unapproved (unauthorised area) ii. Laldora or constructed area iii. Regularized area or TP Scheme iv. Established area by Govt. / Corporation v. Regularized area / Colony

Page No. 2 15. Affidavit reg. Non parking of vehicles in front of the house / institute. Attached on page no. Detail of fees received:- BA Fee Malba Fee v Dev Charges 16. Report of Fee by Accounts Department Security Boundry fee Misc/Form Fee Total Fees Receipt No Dated Acct. Signature Malba Fee (Sq Yard) Charges BA Fees Charges Boundry Wall Charges Development Charges Charges 0-100 Rs 1200 Residential Rs 5 Per SqY Residential Rs 5 per Rft Residential 120 per Sq Yd 101-200 Rs 1800 Commercial Rs 10 Per SqY Commercial Rs 10 per Rft Commercial<30 mt RaRoad 1000 Per Sq Mt 201-300 Rs 4800 Public/Indust Rs 3 Per SqY Public/Indust Rs 3 per Rft Commercial>30 mt RaRoad 1200 Per Sq Mt 301 and above Rs 6000 CLU Charges 155 per Sq Mt 17 Report about validityof old const. B.A. Sanctioned Not sanctioned No need 18. Detail of the building application if approved already Copy Pasted on Page No: 19. Status of notice of unauthorized const. : Last / present status. B.I. Signature 20. Permissible Covered Area on Ground floor Base Ground ment Floor Existing Proposed Existing + Proposed First Floor 21. FAR as per rule Proposed FAR Second Floor Third Floor 22. Space for parking as per rule 23. Space for parking in the proposed building. 24. Property ID as Property Tax Data Total Architect Signature B.I. Signature JE Signature Tax Paid Till Dues If Any Tax Clerk Sign. 25. JE Report about Validity of site of proposed const. I attest to the validity of site report by B.I. J.E. Sign.

Page No. 3 26. Litigation about unauthorized const. at site. Notice u/s. No Dated given / no litigation. 27. Space for car parking in the commercial building as per plot area or parking space is available at site as per plot area 28. Encroachment on Corporation /Govt. Land (encroachmentyes/no) 29. Report by JE Concerned on Impact to Main Road/Street Ramp Needed Estimated Cost if any to be recovered for likely repair of Road Any impact on traffic J.E. Sign. 30. Fire safety measures as per NBC (Yes/ No) F.S.O. Sign. As per provision made in Haryana Municipal Building Bye Laws 1982 (as amended from time to time) and U/s of 250, 251, 252 & 254 of Haryana Municipal CorporationAct, 1994.

Page No. 4 S. No. Name of Colonies S. No. Name of Colonies S. No. Name of Colonies 1 Rampura Colony 58 Ranjeet Gali 117 Sugar Mill Colony 2 Madhu Colony 59 Darshan Gali 118 Ahata Bani Parshad 3 Sharma Garden 60 Sant Pura (Model Town) 119 Old Hamida 4 Kartarpura 61 Shivaji Park (Model Town) 120 Gulati Gali 5 Mahabir Colony 62 D.A.V. Market 121 Baraham Puri (Old Hamida) 6 Nanak Nagar 63 Bhatia Nagar (West) 122 Balmiki Colony (Old Hamida) 7 Patal Puri 64 Sant Pura (Chhoti Line) 123 Gadria Basti (Old Hamida) 8 Mahadev Colony 65 Krishna Gali (Bhatia Nagar) 124 Majri Patel Nagar 9 Raja Ram Colony 66 Bilt Colony (Paper Mill Colony) 125 Krishna Nagar/Colony 10 Prem Colony 67 Jagadhri RoadArea (Old Hamida) 11 Munda Mazra 68 Subhash Nagar Chhoti Line 126 Garhi Village 12 Mazri (Munda Mazra) 69 Joginder Market 127 Laker Mandi 13 Balmiki Mazri (Munda Mazra) 70 Raja Ram Gali 128 Khajuri Road 14 Shastri Colony 71 Bara Kalu Ram 129 Khan Market S.K. Road. 15 Bhatia Nagar East 72 Fridoz Manjil 130 Atma Puri 16 Madan Puri 73 Khera Mohalla 131 Golden Colony 17 Model Colony 74 Khera Bazar 132 Dashmesh Colony 18 Obroi Colony 75 New Market 133 Building House Society 19 Hamida Colony 76 Bazar Radaur Road 134 Azad Nagar-I 20 Vishvakarma Mohalla 77 Devi Mandir Mohalla 135 Azad Nagar (Madhur Colony) 21 Chandan Colony 78 Kabir Gali 136 Professor Colony /Yogesh Nagar 22 Balwant Rai Colony 79 Panjabi Mohalla 137 Ram Nagar 23 Jain Nagar 80 Sant Nagar 138 Chopra Garden (Vishal Nagar 24 Ashoka Colony 81 Johar Mohalla Vikas Nagar & Adarsh Nagar 25 Dhiman Gali 82 Ganesh Mandi Tyagi Garden, Shashi Garden). 26 Bhatia Mohalla 83 Kalsia Sarai 139 Luxmi Nagar. 27 Bishgarha 84 Jawahar Market 140 Krishna Colony Block-B. 28 Rana Lane 85 Kamla Market 141 Tagore Garden 29 Sondhi Mohalla 86 Railway Colony 142 Anand Colony 30 Gadriya Colony 87 Shiv Puri 143 Bishan Dass Colony-A 31 Balmiki Basti (Chuna Bhatti) 88 Dig-Vijay Nagar/ Vijay Nagar 144 Bishan Dass Colony-B 32 Hari Parshad Colony 89 Jaswant Colony 145 Jammu Colony 33 Juble House Colony (Rest House 90 IndustrialArea 146 Kuldeep Nagar Road) 91 Industrial Estate I&II 147 Krishna Nagar (Chandpur) 34 Jamuna Gali 92 Mishra Colony 148 Harbans Pura 35 Anand Market 93 Hari Nagar 149 Inder Puri 36 Obroi Market (Jagadhri Road) 94 Lajpat Nagar 150 Patel Nagar extension 37 Singhara Gali 95 Krishna Colony 151 Veena Nagar extension 38 Vohra Market 96 Sarojini Colony 152 Adarsh Nagar 39 Geeta Market 97 Baraham Puri 153 Indra Garden (Labour Colony) 40 Gandhi Market 98 Modern Colony 154 Ishwar Colony (Sasholi Mazri) 41 Subhash Nagar, Jagadhri Road 99 Parhalad Puri 155 Ganesh/Khadda Colony (Old 42 Kamla Nagar, Chhoti Line 100 Tilak Nagar Hamida) 43 Shivaji Park near Jangla Wali Mata 101 Sasholi Mazri (Ambedkar Colony) 156 Harbans Pura extension Mandir 157 Raja Garden 102 Vishnu Nagar 44 Brij Puri 158 Tilak Nagar Extension 103 Guru Teg Bahadur Nagar 45 Professor Colony (Old) 159 Bawa Colony/Ashok Nagar/Preet 104 Labour Colony 46 Vidya Nagar Nagar 105 Luxmi Garden 47 Gobind Puri 160 Dharam Pura (Harbans Pura) 106 Friends Colony 48 Balmiki Basti (Gobindpuri) 161 Joginder Nagar 107 Chand Pur 49 Shakti Nagar 162 Tara Puri(Vishnu Nagar) 108 Gandhi Nagar 50 Hydel Colony 163 Jain Nagar / Palam Vihar (Camp) 109 Veena Nagar 51 Sham Nagar 164 Gulab Nagar extension 110 Ranjeet Colony/ Nagar (Camp) 165 Rana Market (Khajuri Road) 52 Bindra Colony 111 Tilak Nagar (Camp) 166 Shiv Nagar Colony (Gandhi 53 Model Town 112 Sharma Colony (Camp) Nagar) 54 Kamla Nagar (Model Town) 113 NewAbadi (Camp) 167 Satyam Vihar (Harbans Pura) 55 Prem Nagar 114 Gulab Nagar 168 Others, Specify 56 Bajaji Mohalla 115 Patel Nagar 57 Thapar Colony 116 Power House Colony... We attest to the fact that the proposed building is situated in the area/colony highlighted above. Signature & Seal of Architect Signature & Seal of BI JE Signature

Paste copy of Ownership documents here Page No. 5

Paste Site Photographs (Front & Side View) and Location on Google map here (Size = 4"by3") Page No. 6 FRONT VIEW SITE PHOTOGRAPH SIDE VIEW SITE PHOTOGRAPH SATELLITE MAP PRINTOUT NON-SATELLITE MAP PRINT OUT (FULL ZOOM IN) (ZOOMED OUT LEVEL)

(Paste affidavit regarding non-parking of vehicle here) Page No. 7

(Paste Copy of the building application if approved already) Page No. 8

Page No. 9