Coimbatore Municipal Corporation...
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Coimbatore City Municipal Corporation - Town Planning
C.F No.13 Cost of Form Rs.10/-
Coimbatore Corporation
Application form for issue of License as Licensed Building Surveyor.
A passport size photo of the applicant duly signed by him to be affixed here. (Another copy of photo to be enclosed so as to affix the same in the License order)
The Commissioner,
Coimbatore Corporation.
I desire to serve as Licensed building Surveyor in the city Municipal Corporation of Coimbatore I assure that I will abide to all the rules and regulations etc., issued by the Government Corporation or any other Competent Authority from time to time. I remit herewith necessary License fees and security deposit I also furnish herewith necessary particulars as follows.
1. Name of the applicant :
2. Name of the Father / Husband :
3. Date of Birth (with proof thereof) :
4. Present Address (to which communications are to be send) :
5. Permanent Address (Residential Address) :
6. Technical qualification acquired (with proof thereof) :
S.No Name of exam passed Month & Year of the examination held Certificate No. & Date Authority by whom the certificate was issued
7. Present occupation, if any whether in Govt. or private  :
8. Previous experience if any (with proof thereof)  :
9. Details of license obtained if any in other local bodies  :
10. Whether he has obtained license previously and discontinued (if so the reason for discontinuation such as non-renewal, disqualification, debarment or cancellation etc., to be explained)  :

Signature of the Applicant
* Cost of Form : Rs.10/-
* Cost of Service: Rs.250/- for Diploma Holders, Rs.500/- for BE grade - I