RACHANA
     Archirectu ro I Design
     Plons & Sup ervrslon
                                    APPENDTX'GI
                       FORM T'OR COM PLETION CERTIFICATE
To,
The Authority,
Planning Authority /Collector
Sir,
I hereby certily that the erection / re-erection or partl full development work in / on'building / part
building No                    Plot No 21, Revenue S.No 8,1412,1 Gat No........./ Khasara No........ / City
Survey No 4780/ Final Plot No........., Mouje DeopurnDhule, had been supervised by technical
person and had been completed on t sa-z'zoz3yfithout any departures of substantial nature according
to ihe plans sanctioned,vide office communication No. 2223, dated 08103/2020 .The work had been
completed as per sanctioned plan. No provisions of the Act or the building Regulations, no
requisitions made, conditions prescribed or orders issued thereunder have been transgressed, except a
few changes made within the intemal layout of residential or commercial units, which do not violate
FSI or other regulations, in the course of the work. I am enclosing three eopies of the eompletion
plans. The building is fit for occupancy for which it has been erected/ re-erected or altered,
constructed and enlarged.

I have to request you to an"ange for the inspection & grant permission for the occupation of the
building.

Yours faithfullv



    $$"
(Signature of Owner)

SHRI. PURUSHOTTAM GOPAL KOUJALKT.

Date: lS
                   -C*.-'2-e>?



Signature and name      Architect /Licensed
Engineer/Supervisor


   WASTU RACHAHA ASSOCIATES
    RA'ENDRA S,CHHA'ED
    CONSULTING ENgINEER'S
    REGD NO OlO
    5'A.WAKHARKAR I{AGAR'DHULE
    t 08.9422289905,    8'
                       231680




                5-A, Wakharkar Nagar, Behind Natra!Talkies, DHULE '424 001 Tel. : 02562 " 231680, 309380