Nabadwip Municipality

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OCCASION	SELECT OCCASIONDURGA PUJADOL JATRAKALI PUJARASH UTSAVOTHERS
IF OTHERS PLS SPECIFY
APPLICANT
CONTACT NO.
ALTERNATE CONTACT NO.
Ward	Select Ward 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Street
Holding No.
Organisation
Location
Land Ownership	SELECT NATURE OF LANDORGANISATIONPERSONALMUNICIPAL
Pandal Length	SELECT PANDAL LENGTH 1 Ft. 2 Ft. 3 Ft. 4 Ft. 5 Ft. 6 Ft. 7 Ft. 8 Ft. 9 Ft. 10 Ft. 11 Ft. 12 Ft. 13 Ft. 14 Ft. 15 Ft. 16 Ft. 17 Ft. 18 Ft. 19 Ft. 20 Ft. 21 Ft. 22 Ft. 23 Ft. 24 Ft. 25 Ft. 26 Ft. 27 Ft. 28 Ft. 29 Ft. 30 Ft. 31 Ft. 32 Ft. 33 Ft. 34 Ft. 35 Ft. 36 Ft. 37 Ft. 38 Ft. 39 Ft. 40 Ft. 41 Ft. 42 Ft. 43 Ft. 44 Ft. 45 Ft. 46 Ft. 47 Ft. 48 Ft. 49 Ft. 50 Ft. 51 Ft. 52 Ft. 53 Ft. 54 Ft. 55 Ft. 56 Ft. 57 Ft. 58 Ft. 59 Ft. 60 Ft. 61 Ft. 62 Ft. 63 Ft. 64 Ft. 65 Ft. 66 Ft. 67 Ft. 68 Ft. 69 Ft. 70 Ft. 71 Ft. 72 Ft. 73 Ft. 74 Ft. 75 Ft. 76 Ft. 77 Ft. 78 Ft. 79 Ft. 80 Ft. 81 Ft. 82 Ft. 83 Ft. 84 Ft. 85 Ft. 86 Ft. 87 Ft. 88 Ft. 89 Ft. 90 Ft. 91 Ft. 92 Ft. 93 Ft. 94 Ft. 95 Ft. 96 Ft. 97 Ft. 98 Ft. 99 Ft. 100 Ft.
Pandal Width	SELECT PANDAL WIDTH 1 Ft. 2 Ft. 3 Ft. 4 Ft. 5 Ft. 6 Ft. 7 Ft. 8 Ft. 9 Ft. 10 Ft. 11 Ft. 12 Ft. 13 Ft. 14 Ft. 15 Ft. 16 Ft. 17 Ft. 18 Ft. 19 Ft. 20 Ft. 21 Ft. 22 Ft. 23 Ft. 24 Ft. 25 Ft. 26 Ft. 27 Ft. 28 Ft. 29 Ft. 30 Ft. 31 Ft. 32 Ft. 33 Ft. 34 Ft. 35 Ft. 36 Ft. 37 Ft. 38 Ft. 39 Ft. 40 Ft. 41 Ft. 42 Ft. 43 Ft. 44 Ft. 45 Ft. 46 Ft. 47 Ft. 48 Ft. 49 Ft. 50 Ft. 51 Ft. 52 Ft. 53 Ft. 54 Ft. 55 Ft. 56 Ft. 57 Ft. 58 Ft. 59 Ft. 60 Ft. 61 Ft. 62 Ft. 63 Ft. 64 Ft. 65 Ft. 66 Ft. 67 Ft. 68 Ft. 69 Ft. 70 Ft. 71 Ft. 72 Ft. 73 Ft. 74 Ft. 75 Ft. 76 Ft. 77 Ft. 78 Ft. 79 Ft. 80 Ft. 81 Ft. 82 Ft. 83 Ft. 84 Ft. 85 Ft. 86 Ft. 87 Ft. 88 Ft. 89 Ft. 90 Ft. 91 Ft. 92 Ft. 93 Ft. 94 Ft. 95 Ft. 96 Ft. 97 Ft. 98 Ft. 99 Ft. 100 Ft.
Pandal Height	SELECT PANDAL HEIGHT 1 Ft. 2 Ft. 3 Ft. 4 Ft. 5 Ft. 6 Ft. 7 Ft. 8 Ft. 9 Ft. 10 Ft. 11 Ft. 12 Ft. 13 Ft. 14 Ft. 15 Ft. 16 Ft. 17 Ft. 18 Ft. 19 Ft. 20 Ft. 21 Ft. 22 Ft. 23 Ft. 24 Ft. 25 Ft. 26 Ft. 27 Ft. 28 Ft. 29 Ft. 30 Ft. 31 Ft. 32 Ft. 33 Ft. 34 Ft. 35 Ft. 36 Ft. 37 Ft. 38 Ft. 39 Ft. 40 Ft. 41 Ft. 42 Ft. 43 Ft. 44 Ft. 45 Ft. 46 Ft. 47 Ft. 48 Ft. 49 Ft. 50 Ft. 51 Ft. 52 Ft. 53 Ft. 54 Ft. 55 Ft. 56 Ft. 57 Ft. 58 Ft. 59 Ft. 60 Ft. 61 Ft. 62 Ft. 63 Ft. 64 Ft. 65 Ft. 66 Ft. 67 Ft. 68 Ft. 69 Ft. 70 Ft. 71 Ft. 72 Ft. 73 Ft. 74 Ft. 75 Ft. 76 Ft. 77 Ft. 78 Ft. 79 Ft. 80 Ft. 81 Ft. 82 Ft. 83 Ft. 84 Ft. 85 Ft. 86 Ft. 87 Ft. 88 Ft. 89 Ft. 90 Ft. 91 Ft. 92 Ft. 93 Ft. 94 Ft. 95 Ft. 96 Ft. 97 Ft. 98 Ft. 99 Ft. 100 Ft.
Idol Height	SELECT IDOL HEIGHT 0 Ft. 1 Ft. 2 Ft. 3 Ft. 4 Ft. 5 Ft. 6 Ft. 7 Ft. 8 Ft. 9 Ft. 10 Ft. 11 Ft. 12 Ft. 13 Ft. 14 Ft. 15 Ft. 16 Ft. 17 Ft. 18 Ft. 19 Ft. 20 Ft. 21 Ft. 22 Ft. 23 Ft. 24 Ft. 25 Ft. 26 Ft. 27 Ft. 28 Ft. 29 Ft. 30 Ft. 31 Ft. 32 Ft. 33 Ft. 34 Ft. 35 Ft. 36 Ft. 37 Ft. 38 Ft. 39 Ft. 40 Ft. 41 Ft. 42 Ft. 43 Ft. 44 Ft. 45 Ft. 46 Ft. 47 Ft. 48 Ft. 49 Ft. 50 Ft. 51 Ft. 52 Ft. 53 Ft. 54 Ft. 55 Ft. 56 Ft. 57 Ft. 58 Ft. 59 Ft. 60 Ft. 61 Ft. 62 Ft. 63 Ft. 64 Ft. 65 Ft. 66 Ft. 67 Ft. 68 Ft. 69 Ft. 70 Ft. 71 Ft. 72 Ft. 73 Ft. 74 Ft. 75 Ft. 76 Ft. 77 Ft. 78 Ft. 79 Ft. 80 Ft. 81 Ft. 82 Ft. 83 Ft. 84 Ft. 85 Ft. 86 Ft. 87 Ft. 88 Ft. 89 Ft. 90 Ft. 91 Ft. 92 Ft. 93 Ft. 94 Ft. 95 Ft. 96 Ft. 97 Ft. 98 Ft. 99 Ft. 100 Ft.

Total Pit in Municipal Land
Pit in Metal Road	SELECT NO. OF PIT 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
Pit in Brick Road	SELECT NO. OF PIT 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
Pit in Mud Road	SELECT NO. OF PIT 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
Permission Required From
Permission Required Upto
Permission Type	SELECT PERMISSION TYPERENEWALNEW
Previous Permission No.
Previous Permission Date

President
S/D/W of
Vice President
S/D/W of
Secretary
S/D/W of
Treasurer
S/D/W of
Name of Members
1.
S/D/W of
2.
S/D/W of
3.
S/D/W of
Organiser Type	SELECT ORGANISERRUN BY FEMALERUN BY MALE
Immersion Place Select "NOT APPLICABLE" option for Temporary Structure Permission	SELECT PLACE OF IMMERSIONRIVER GANGESNEARBY PONDNOT APPLICABLE
Immersion Date Date of Cleaning Surrounding Area for Temporary Structure

Declaration on behalf of the organisation

এতদ্দ্বারা অঙ্গীকার করিতেছি যে, পূজা কমিটি আয়োজিত পূজামণ্ডপ আলোকসজ্জার জন্য যে ব্যবস্থাদি অনুমতিপত্র গ্রহণ করিতেছি, উক্ত অনুমতিপত্রের নির্দিষ্ট সময়ে উল্লেখিত স্থানে রাস্তার কোনো রকম ক্ষতি করা হইবে না এবং সাধারণ যানবাহন ও জনসাধারণের চলাচলের কোন প্রকার বিঘ্ন করা হইবে না | এছাড়াও বর্তমান করোনা অতিমারি পরিস্থিতিতে, পশ্চিমবঙ্গ সরকারের, সাধারণ প্রশাসন পুলিশ প্রশাসন ও স্বাস্থ্য প্রশাসনের সমস্ত বিধি মানিয়া অঙ্গীকার ভঙ্গ করলে তার জন্য নবদ্বীপ পৌরসভা আমার আমাদের বিরুদ্ধে আইন মোতাবেক শাস্তি মূলক ব্যবস্থা গ্রহণ করিতে পারিবে |