FORM-1

Prescribed under Rule 3

Application For Permission To Construct Extent Takes Into Use Any Building As A Factory

UBIN Details

UBIN *

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Where to Apply *

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Factory And Applicant Details

Name of the Applicant *

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Address of the Applicant *

Address Line 1 *

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Address Line 2

Address Line 3

Country *

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State *

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District

Postal / Zip Code *

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Mobile Number *

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Telephone Number

E-Mail *

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Full name of the factory *

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Postal address of the factory *

Address Line 1 *

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Address Line 2

Address Line 3

Country *

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State *

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District

Postal / Zip Code *

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Mobile Number *

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Location of the Factory *

Address Line 1 *

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Address Line 2

Address Line 3

Country *

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State *

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District

Postal / Zip Code *

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Nearest railway station *

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Particulars of Plants and Machinery to be installed *

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Nature of Manufacturing Powers/ Inputs/ Outputs/ Wastages *

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Site Plan

Historical monument, if any, in the vicinity

Names of neighboring manufacturing units & human habitats, Educational & training institutions, patrol installations storages of LPG & other hazardous substances in the vicinity & their distances from the proposed unit

Water sources(rivers, streams, canals, dams, water filtration plants etc.) in the vicinity

Nearest hospitals, fire-stations, civil defense stations & police stations & their distances

High tension electrical transmission line, pipe lines for water ,oil, gas or sewerage, railway lines, roads,stations,jetties & other similar installations

Details of soil conditions & depth at which hard strata obtained

Project Report

A summary of the salient features of the project

Status of the organization (Govt. Semi Govt. Public or private etc.)

Maximum number of persons likely to be working in the factory

Maximum amount of power & water requirements & sources of their supply *

Power (in units)

Water(in units)

Source

Details of housing colony, hospital, school & other infrastructural facilities proposed

Area allocated for treatment of wastes & affluent

Percentage outlay on safety, health & environment protection measures(in%)

Communication Links

Availability of telephone/telex wireless & other communication facilities for outside communication

Internal communication facilities proposed