FORM-C

Form of undertaking to be executed by the land owner or power of attorney

holder or builder or promoter and structural engineer, architect, geo-tech expert and
site engineer.

This deed of undertaking executed at ………….on the…………………day of

……………………20….. by the landowner Thiru/Tmt/Selvi ……………………………………
Son/Daughter of …………………………………. aged…………………………..Residing at
No.………………………………………………………………..... (or) Power of Attorney Holder (or)
Builder (or) Promoter / Structural Engineer __________, Architect __________________, Geo-
Tech Consultant __________________ in respect of proposed development / construction
made in Door No._________, _________________ Road in the following S.No.

S.No. / R.S.No. / T.S.No. Block No. Village Taluk

in favour of the ……………………………………….(competent authority) having office at

………………………………………….witnesseth as follows.

2. I/We (Land Owner or Power of Attorney Holder or Builder or Promoter) have

applied for the Planning Permission for construction in the above premises by submitting
an application to the ………………………………..(competent authority)in accordance with the
planning norms prescribed in these rules. I am associated with the project as Land
Owner/Power of Attorney Holder/Builder/Promoter. The extent of site as per document is
_____ sq.m. and as per Patta / TSLR / PLR / Handing over sketch _______ sq.mt. I assure
that I will put up the construction only in accordance with the approved plan without any
deviation and if any construction is later on found not in accordance with the approved
plan and any unauthorized addition is made, I agree for the forfeiture of the Security
Deposit which will be collected while issuing Planning Permission, and also agree to
demolish the such a deviation marked by the ………………………………………..(competent
authority) within thirty days after such notice, failing which, apart from forfeiture of
Security Deposit, the ……………………………………………………… may demolish or cause to
demolish such unauthorized or deviated constructions at the site under reference and
recover the cost of demolition from me.
3. I/We (Land Owner or Power of Attorney Holder or Builder or Promoter) also
assure that the open space around the building to be left or the usage of the building,
including the car parking in ground floor, will be kept as specified in the approved plan and
it will not be converted into any other use except the purpose for which it is approved. If
any structural modification or usage differs from the approved plan, the competent
authority is at liberty at any time to remove any structural modification or usage and the


expenses incurred by the competent authority is recoverable from me for non-compliance of

their request or order.
4. I/We (Land Owner or Power of Attorney Holder or Builder or Promoter) further
assure that I will not convert any place of the construction in contravention to the approved
plan, especially in respect of car parking as specified in the sanctioned plan. At any time in
future, I will not convert the car parking on stilts by covering them fully, and use the car
parking space for any other purposes. If any construction work in car parking place,
converting them either as a flat or for any other purpose, is done either by me or by my
successor or by any other person to whom the said construction is transferred in future,
without getting appropriate order for doing so from the competent authority, the Authority
is at liberty at any time to take any action to remove any structural modification or usage
and the expenses incurred by the Authority is recoverable from me/my successor or from
any other person to whom the said construction is transferred in future.
5. I/We (Land Owner or Power of Attorney Holder or Builder or Promoter) hereby
undertake that, I am, jointly and severally responsible with the Land Owner/Power of
Attorney Holder/Builder/Promoter to carry out the developments in accordance with the
permission granted and also for payment of Development Charges, Security Deposit,
Scrutiny Fee and for all other charges levied from time to time by the Authority and also
liable for penal provisions for developments made in contravention of the Development
Regulations and these presents.
6. I/We (Land Owner or Power of Attorney Holder or Builder or Promoter) assure
that I/We will pay the premium FSI charges as applicable in case the FSI area exceeds the
permissible FSI as per Development Regulations.
7. I/We (Land Owner or Power of Attorney Holder or Builder or Promoter) assure
that I / We shall gift the OSR area as applicable or pay the equivalent land cost in lieu of
OSR area as per Development Regulations.
8. I/We (Land Owner or Power of Attorney Holder or Builder or Promoter) assure
that I / We shall gift the Street Alignment Portion / Road Widening Portion / Link Road as
per the provisions in the Development Regulations to the Authority / Localbody before issue
of Planning Permission.
9. I/We (Land Owner or Power of Attorney Holder or Builder or Promoter) hereby
solemnly affirm and declare that I / We are the absolute owner / owners / Power of
Attorney Agent / Lease Holder of the said property and it is not covered under the Land
Ceiling and Land Acquisition (in respect of Land Acquisition Act, 1894, The Right to Fair
Compensation and Transparency in Land Acquisition, Rehabilitation and Resettlement
(Amendment) Ordinance, 2015, Land Reforms Act, 1961 and Land Ceiling Act, 1978) and I
/ We shall be liable for all future consequences in case of land falling under Land Ceiling,
Land Reforms or Land Acquisition.
10. I / We (Land Owner or Power of Attorney Holder or Builder or Promoter) have
engaged the following as the consultant for the proposed development:
Consultant Name and Registration No. E-Mail Signature
Address ID & Mobile No.

Architect / L.S.
Structural
Engineer

Geo-Tech Expert

Site Supervision
Engineer
 This is to certify that I the Architect / LS of the site has inspected the site at

S.No. / R.S.No. / T.S.No. Block No. Village Taluk

I, the Architect / Licensed Surveyor certify that

The ………………………..Road abutting the site under reference is public

(maintained by the Local Body) and its width actually measures ………m in front of the site
and qualifying width of …..m is available for a length of 250m / 500m as shown in the Road
width sketch enclosed mentioning width of the road at regular interval of 25 m mentioning
the landmark of the stretch where width has been measured.
I have personally verified the site measurements on ground and dimensions given in
the plan correspond with the actual on the ground.
The residuary plot details including structures thereon evidenced by documents
correspond with the actual on the ground.
Distance between the site and nearby waterbody, if any, is _____ m.
Distance between the site and quarry / crusher, if any, within 500m is ------ m
Distance between the site and burial ground , if any, within a distance of 30 m
from a place declared and used as a burning or burial place / ground is -----m
The Street Alignment Portion / Road Widening Portion / OSR Area shown in the Site
Plan tallies to the dimensions in the ground condition.
The site approval for Non High Rise Buildings / High rise building is enclosed (in
such cases item No.1 to 7 does not arise).
The building plans prepared and submitted herewith satisfy the relevant provisions
of development regulations vide planning parameters compliance statement.
The site lies vacant (or) not.
The depth of the plot with reference to road level is _______ m.
HT / LT line passes through the site : Yes / No
(If yes, to be shown in the site plan)
Topo Plan furnished showing the surrounding developments for a radius of 500 m
correspond with the actual on the ground.
The coverage of the building mentioned in the Plan is correct.
In case of non-issuance of NOC, I shall obtain NOC / remarks from the department’s
concerned before commencement of the construction and comply the conditions stipulated
by the concerned NOC /Remarks issuing Department during the construction and submit


the NOC / remarks along with certificate from the concerned agencies on fulfillment of the
NOC conditions at the time of applying for Completion Certificate.
I the Architect / LS to inform competent authoritybefore the commencement of
crucial stages of construction viz.
Earth work for foundation
Foundation concreting
Laying the roof of basement floor
Laying the roof at each floor level
After completing the finishing work
(White washing, colouring, fixing, water supply, drainage or other sanitary fitments)
and before obtaining regular connection for water supply / electricity.
I the Architect / LS also undertake to communicate to …………………………
(competent authority)Certificate to the effect that the construction is in conformity with the
plan approved by competent authorityat the crucial stages mentioned above.
If any deviation to the approved plan is proposed to be made, I the Architect / LS
shall obtain prior approval of the Chennai Metropolitan Development Authority
I the Architect / LS shall intimate ………………………….(competent
authority)immediately if for any reasons association with the project ceases
The above information furnished is correct. If any information furnished is found
wrong, I am aware that action shall be initiated against me and I shall not be henceforth
allowed to sign in the Plans for the Planning Permission Applications processed by GCC,
Local Body, CMDA and DTCP. To this effect an Undertaking shall be obtained from
Architect / Licensed Surveyor and owner.
SIGNATURE OF THE ARCHITECT /ENGINEER
We (Owner / Builder / Structural Engineer / Architect / Geo-Tech Expert)
certify that the structural plans of the building meet the structural safety requirements for
all situations including natural disasters, as applicable, as stipulated under Part 6
Structural Design of the National Building Code of India and other relevant Codes; T he
design has been done after detailed soil test and we are satisfied as to the adequacy of soil
test carried out and the information given therein is factually correct to the best of our
knowledge and understanding.
T he site is fit for the proposed construction, it has been tested vide soil test report.
No......................... dt..................... done by ...................................
We (Owner / Builder / Structural Engineer / Architect / Site Engineer) certify that
the development, erection, re-erection or making alteration in the building shall be carried
out under our supervision and we certify that all the materials (type and grade) and the
workmanship of the work shall be generally in accordance with the general and detailed
specifications, as per NBC standards and to meet out the structural design of the proposed
building.
We (Owner / Builder / Structural Engineer / Architect / Site Engineer) undertake
not to continue construction without any supervis ion by the our Site Engineer and submit
the report to the local body.
I (Landowner / Builder ) certify to engage the above mentioned Engineers for the
active period of building execution and I hereby assure to give Revised Certificate in case of
any change of Engineer, I shall ensure no work is taken up in this period till required
Engineers are engaged by me.
In case construction work is entrusted by a Builders Agreement to a 3rd Party, I
(Land Owner or Power of Attorney Holder or Builder or Promoter)shall undertake to include
these conditions as part of the agreement.
 Applicable incase of existing building within the site
I (Structural Engineer / Architect / Site Engineer) hereby certify that the
development, erection, re-erection or for making alteration in the building has been carried
out under our supervision and we certify that all the materials (type and grade) and the
workmanship of the work was in accordance with the general and detailed specifications, as
per NBC standards and met out the structural design of the constructed building. The
construction was made under the supervision of Site Engineer and submitted the report to
the local body periodically.
I (Owner / Builder / Structural Engineer / Architect) hereby certify that the
building, has been designed by me ………………………………………………and the Structural
Design was made by Thiru ……………………………………………………………… to the
approved plans sanctioned in the Planning Permission No. ………………………… dated
…………………… and the Building Permit No………………………………
dated………………………….. The Building has been constructed and completed under my
guidance and supervision as per the structural design furnished by the Structural Engineer
engaged by us. I also assure and undertake that, I have signed in the plan and in “as on
site” plan and the same is structurally safe and fit for occupancy based on my personal
assessment and certification of the Structural Engineer engaged by us.
This deed of undertaking is executed by us on the…………………….day
of…………………………………….20………….with the full knowledge of the contents of this
document.

Consultant Name and Registration No. E-Mail ID & Signature

Address Mobile No.

Owner of the
land / Power of
Attorney Holder /
Lease Holder

Architect / L.S.

Structural
Engineer

Geo-Tech Expert

Site Supervision
Engineer

DEPONENT

Witnesses:

1.

2.

Duly attested by the

SEAL Notary Public