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
b) 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	:
		6P3N
*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
Note : 4 . BEAUTIFICATION NOTIFICATION

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