Common Application Form Ia
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Transcript of Common Application Form Ia
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8/18/2019 Common Application Form Ia
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COMMON APPLICATION FORM IPART A
FOR ESTABLISHMENT
This format is to be filed with the Nodal Agency for the purpose of arranging site clearance, statutory approvals fromGram Panchayat, Municipality, TC & P, Urban Development Authority, Factories, Alienation of land / Acquisition of land,Power feasibility and Power connection from DISCOM, sanction of water supply from local bodies / HMWS & SB / Groundwater for setting up of industrial units in A.P.
(Please submit required number of copies as per check slip including one for your record)
NAME & ADDRESS OF THE PROMOTER/INDUSTRIAL UNDERTAKING IN FULL1.1
Name of the Industrial Undertaking bondus engineering enterprise
Name of the Promoter/M.D./Mg. Partner withsurname first
bondu sudha rani
S/o./D/o./W/o. naveen kumar
Age 43
Occupation buissiness
UID (Aadhar ID) 592508808097
ADDRESS FOR COMMUNICATION1.2
Door No. pno-308
Street Name devudu cheruvu
Village/Town ongole
Mandal ongole
District prakasam
Pin Code 523001
E-mail [email protected]
Fax
Telephone (incl. STD code) 9611442479
2 Nature of Organisation : Proprietary
3 For Proprietary Units Only. Do you belong to : SC
Line of manufacture4.1
S.No Item Description Annual Installed Capacity
Units Quantity
1 motor vehicle spares nos 2000
2 engg goods nos 2000
Applicatin ID: CAE1501897
GOVERNMENT OF NDHR PR DESH
DEP RTMENT OF INDUSTRIES
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Date:07/04/2016
Signature of Promoter or authorised person only in Ink
NAME (IN BLOCK LETTERS)
(DESIGNATION)
Power required for the unit9.0
Contracted Load is 11KV or 33KV (53)
Contracted Load Maximum Demand in HP 74
Aggregate installed capacity of the transformer to be installed bythe entrepreneur in case of H.T. (H.T. means above 150 H.P.)
74
Proposed maximum working hours 20 Per day
600 Per month
Expected month and year of trial production 12 - 2015
Probable date of requirement of power supply. 05/11/2015
Total HP of the machinery proposed to be installed 74
Is Power Installation above 650V No
Water Supply and Sewer connection10
Water Supply from APIIC
Water requirement
i) Drinking Water 500 KL/Day
ii) Water for Processing (Industrial Use) 200 KL/Day
Size of Water Supply connection applied for 25mm(1”)
Size of sewer connection applied for 25mm(1”)
Area for Survey 0.50 Acres
Permission to draw water11
Agency Ground Water
Requirement of Water Quantity 3000KL/Day
I declare that the particulars given above are true to the best of my knowledge and belief. I shallobey the rules and regulations in force. If any deviation is found, suitable action may be initiated.
Place :
