Application For Beautification

Application Form for Beautification Work on the Government Land along canal / drainage channel / river embarkment, belonging to Irrigation & Waterways Department, Government of West Bengal by private persons / entities (other than Government Departments / Organisations / Undertakings )


1. Name & Contact details of the Applicant
a) Name* :
b) Status* (Individual / Authorised Signatory for ) : Society Company Firm
c) Name of Firm / Company / Society (If applicable , otherwise mention 'NA')* :
d) Address* :
e) Landline No* :
f) Mobile No * :
g) Email * :
2. Name of the river / channel / canal over which beautification work is proposed
a) Name of the river * :
b) Name of the channel * :
c) Name of the canal * :
3. Location of the proposed beautification work
a) Mouza / Village / Locality * :
b) Gram Panchayat / Municipal work * :
c) PanchayatSamity / Municipality * :
d) Police Station * :
e) District * :
4. Appropriate geo-referencing of the location
a) Latitude * :
b) Longitude * :
5. Name of the industrial campus / residential campus with RS plot no. Dag no. of the premises associated with the proposed beautification
a) RS Plot No. * :
b) Dag No. * :
c) Khatian No. * :
6. Distance of premises (for the benefit of which the beautification is proposed ) from thr proposed beautification site.
a) : Metre
7. Whether approach from the premises to the beautification site is existing or has to be constructed / developed
a) : Contructed To Be Developed Existing
8. Proposed / existing width of the approach road
a) : Metre
9. In Case the aforesaid approach road is to be constructed / developed , name of the implementing / executing authority for such development and name of the local authority for according permission for the same. Such local authority may be panchayat samity in rural areas and Municipality/Municipal Corporation/development authority in urban and semi-urban areas
a) :
10. Reference number and date of NoC of the local authority regarding taking up beautification with approach, if any . Such authority may be panchayat samity in rural areas and Municipality/Municipal Corporation/development authority for urban areas .
a) Ref No. :
b) Date :
11. Justification of the proposal of the proposed beautification work (Within 3 lines / sentences. )
a) :
12. Type of Proposed beautification work
a) : Only Plantation Only Decorative Walkway Combination of plantation and walkway Any Other Item
13. Total length and width of the proposed beautification
b) Length : (metre)
a) Width : (metre)
14. Attach the scanned copies of the following :
a) Index plan preferably drawn on mouza map, showing the proposed beautification , approaches on the plots belonging to I&WD/Government, plot of the premises for which the beautification is proposed and alignment of the access/approach road , from the beautification site up to the entrance of the premises . :
b) Letter of Local Authority according NoC (vide Sl. 10) :
c) layout drawing of the proposed beautification prepared by Licensed Architect showing Plan / Elevation :
*Enter Text as displayed in Image :
Note : 1 . Standard Operating Procedure (SOP) for processing the application has been detailed at Annex-II
Note : 2 . Guiding principles to be followed in the Irrigation & Waterways Department to accord permission is detailed at Annex-III
Note : 3 . Standard format of undertaking to be submitted by the Applicant is at Annex-IV