1. Name & Contact details of the Applicant
a) Name*
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b) Status* (Individual / Authorised Signatory for )
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c) Name of Firm / Company / Society (If applicable , otherwise mention 'NA')*
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d) Address*
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e) Landline No*
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f) Mobile No *
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g) Email *
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2. Name of the river / channel / canal over which new bridge / culvert work is proposed
a) Name of the river *
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b) Name of the channel *
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c) Name of the canal *
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3. Location of the proposed new bridge / culvert work
a) Mouza / Village / Locality *
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b) Gram Panchayat / Municipal work *
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c) PanchayatSamity / Municipality *
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d) Police Station *
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e) District *
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Select District Alipurduar Bankura Birbhum Bokaro Coochbehar Dakshin Dinajpur Darjeeling
Deoghar Dhanbad Dumka East Sikkim Hooghly Howrah Jalpaiguri Jhargram Kalimpong Koderma Kolkata Kurseong Malda Murshidabad Nadia North 24 Parganas Paschim Bardhaman Paschim Medinipur Purba Bardhaman Purba Medinipur Purulia South 24 Parganas Uttar Dinajpur
4. Appropriate geo-referencing of the location
a) Latitude *
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b) Longitude *
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5. Name of the industrial campus / residential campus with RS plot no. Dag no. of the premises associated with the proposed new bridge
a) RS Plot No. *
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b) Dag No. *
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c) Khatian No. *
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6. Distance of premises (for the benefit of which the new bridge / culvert is proposed ) from thr proposed new bridge / culvert site along alignment, for alternate access .
a)
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7. Whether alternate access, stated at SL. 6. above is existing or has to be constructed / developed
a)
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8. Proposed / existing width of the alternate access road
a)
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9. In Case the alternate access is to be constructed / developed , name of the implementing / executing authority for such development and name of the local authority for according permission . Such local authority may be panchayat samity in rural areas and Municipality/Municipal Corporation/development authority in urban and semi-urban areas
a) Name of the implementing / executing authority
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b) Name of the local authority
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10. Reference number and date of letter of NoC of the local authority regarding construction of the new bridge / culvert . Such authority may be panchayat samity in rural areas and Municipality/Municipal Corporation/development authority for urban areas .
a) Ref No.
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b) Date
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11. Justification of the proposal of the proposed new bridge / culvert work (Within 3 lines / sentences. )
a)
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12. Type of Proposed new bridge / culvert
a)
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Note 1 : Footbridge is mainly for pedestrian traffic with occasional 4-wheeler, carriageway width 2.0m.
Note 2 : Single lane bridge for higher category of traffic carriageway width of 4.2m , upto 20m total spans.
Note 3 : Double lane bridge of minimum carriageway width of 5.5m , beyond 20m total span or heavier traffic density even at lower span.
13. Total length and width of the proposed new bridge / culvert
a) Length
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a)Carriageway Width
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14. Distance of the nearest new bridge / culvert in upstream and downstream from the proposed new bridge / culvert location
a) Upstream
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b) Downstream
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15. Attach the scanned copies of the following :
a) Index plan preferably drawing of mouza map, showing the proposed new bridge / culvert , approaches on the plots belonging to I&WD/Government, plot of the premises for which the new bridge / culvert is proposed and alignment of the access/approach road , from the new bridge / culvert site up to the entrance of the premises .
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b) Letter of Local Authority according NoC (vide Sl. 10)
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c) General arrangement drawing of the new bridge / culvert prepared by licenced structural Engineer showing :
> Plan
> Elevation
> Typical cross section of the structure, superimposed of the river / channel / canal section
> Typical cross section of the proposed protection work in upstream as well as downstream for a length of 15m from center line of bridge axis by brick block pitching / stone bloulder pitching / cement concrete block pitching over a layer of filter
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*Enter Text as displayed in Image
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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 for construction of bridge / culvert over rivers / drainage channels / irrigation canal may be perused at Annex-III
Note 3 : Standard format of undertaking to be submitted by the Applicant is at Annex-IV
Note : 4 . CONSTRUCTION NOTIFICATION
