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Online Application For Way Leave Facilities/Easement Rights: 1. Applied To 2. Purpose 3. Applicant

This document is an online application for way leave facilities or easement rights on a railway. It collects information about the applicant such as their name, address and contact details. It also requests details about the specific facility being applied for such as its location, type of crossing (pipeline, road over bridge, etc.), size and dimensions. The applicant needs to submit the completed application form along with a sketch, signed agreement and registration fee to the Divisional Railway Manager's office within a week for formal registration.

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Ranjan Kumar Sahoo
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443 views2 pages

Online Application For Way Leave Facilities/Easement Rights: 1. Applied To 2. Purpose 3. Applicant

This document is an online application for way leave facilities or easement rights on a railway. It collects information about the applicant such as their name, address and contact details. It also requests details about the specific facility being applied for such as its location, type of crossing (pipeline, road over bridge, etc.), size and dimensions. The applicant needs to submit the completed application form along with a sketch, signed agreement and registration fee to the Divisional Railway Manager's office within a week for formal registration.

Uploaded by

Ranjan Kumar Sahoo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Online Application

For Way Leave Facilities/Easement Rights


Reporting Date: 10/03/2015

Application ID : _________________ Date : _________________


1. Applied to :DRM/Engg., ___________________________________
2. Purpose :______________________________________________
3. Applicant :______________________________________________
3.1 Applicant Name :______________________________________________
3.2 Auth. Signatory :______________________________________________
3.3 Designation :______________________________________________
______________________________________________
3.4 Address : ______________________________________________
______________________________________________
3.5 Landline No. :______________________________________________
3.6 Mobile :______________________________________________
3.7 Email :______________________________________________
4. Location
4.1 Between Stations :_____________________ and _____________________
4.2 Railway KM/TP :_____________________ and _____________________
4.3 Revenue Village :______________________________________________
4.4 Tehsil :______________________________________________
4.5 District :______________________________________________
4.6 State :______________________________________________
5. Detail of crossing
5.1 PIPELINE :
Carrier pipe(Type & size) :______________________________________________
Casing pipe(Type & size) :______________________________________________
5.2 ROB :
Length in Railway Land :____________________________________________ m
Number of Lanes :______________________________________________
5.3 RUB :
Length in Railway Land :____________________________________________ m
Number of Lanes :______________________________________________
5.4 CULVERT/BOX :
Length in Railway Land :____________________________________________ m
Size :______________________________________________
5.5 OTHER :
Specify :______________________________________________
6. Fee Mode(Rs.2000/-) :DD/Banker's Cheque / MR (Money Receipt)
6.1 No. :______________________________________________
6.2 Date :______________________________________________
6.3 Issuing Bank/Name of Station :______________________________________________
Note :
1. Duly filled Application form should be downloaded, signed, and enclosing a copy of rough sketch and
draft agreement duly signed (on each page) by the applicant should be sent to DRM/Engg. of the
Division within one week of online registration by speed post / registered post.
2. The formal registration will be done after receipt of duly signed application form.
3. Application form without rough sketch, draft agreement duly signed by applicant (on each page) and
registration fee shall be considered incomplete and be summarily rejected.
4. The demand draft(DD) should be prepared in favour of Senior Divisional Finance Mananger of the
concerned Division payable at the divisional head quarter's station.
(______________________)
(Signature of the Applicant)

Seal(in case other than individual)


Date:

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