Annexure – III [See rule 6

(9)] 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. / R.S.No. / Block No. Village Taluk

T.S.No.

S.No. 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
 ................................................................................................................. (compete
nt
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.

2. 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.
3. 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.
4. 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.
5. 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.

6. 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.
7. 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.
 8. 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.

2. 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
Supervisio
n Engineer

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

S.No. / Block No. Village Taluk

R.S.No. /
T.S.No.

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.
........................................................................................................................ date
d
…………………… 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 E-Mail ID Signature

Address No. &
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
 Planning Permission Application is processed based on the
compliance to land use provisions in the respective development plan in
force and the Tamil Nadu Combined Development and Building Rules;

Compliance to the Provisions of other relevant Act and Rules with

respect to construction is the responsibility of the applicant or owner and
the competent authority is not responsible for any lapse;
Planning Permission for buildings is issued in accordance with the
provisions of the Town and Country Planning Act, 1971. and the rules
made there under.
Issuance of Planning Permission by competent authority under the
statutory provisions does not confirm any ownership or title over the
property, in favour of the applicant. Before issuing Planning Permission
for any development, competent authority in this regard, checks only the
aspect of applicant’s right over the site under reference to make the
development thereon based on the copies of the documents (such as Sale
Deed, Patta, Lease Deed, Gift Deed etc., and GPA) furnished by the
applicant along with his /her application to prove the same. Thus,
competent authority primarily considers only the aspect whether the
applicant prima facie has a right to carry out development on the site
under reference.

Any person who acquires interest in the property shall ensure

independently about the ownership and the applicant’s right before
acquiring the same. Further, if any individual claim right (or) title over
the property he / she / they shall have to prove it before the appropriate or
competent Court to decide on the ownership or get the matter settled in
the Court of Law and competent authority is not the statuary authority to
decide on this matter.