FORM 2
Regulations 20(2), 21(3) and 22(3)
APPLICATION FOR BUILDING PERMIT FOR TEMPORARY BUILDING*,
RESIDENTIAL/COMMERCIAL BUILDING* OR COMPLEX
STRUCTURE /PUBLIC BUILDING*
To: The Building Committee
1. Particulars of applicant:
(a) Name: EUGEN EMURON & MOLLY NINA ACAN
(b) Physical address: GAYAZA, WAKISO DISTRICT
(c) Postal address:
(d) Telephone (fixed line):
(e) Mobile phone: (f) 0774 876 991
Fax:
(g) E-mail address:
(h) Identification number (in case of an individual):
(i) Name of contact person (where different from applicant):
2. Legal status of applicant
Please indicate the applicant's legal status (Attach the certificate of incorporation,
memorandum, and articles of association, where applicable).
3. Particulars of directors:
Name Address Nationality Country of usual residence
(a) 1
(b)
3. Description of the proposed building operation Category
Temporary building……………………………………
A……………………………………………………………
B…………………………………………………………..
4. Description and location of site
Plot No 2266 Block No 7 Location OPIYIA
Building Name
Owner and
address
5. Statement of the proposed costs and financing
6. Accessibility to Services
S/N DESCRIPTION YES NO N/A
1 Access Road Y
2 Water supply NWSC
3 Sewer connection N
Y
4 Electricity supply
Y
5 Internet supply
6 Others
7. Professionals engaged, where applicable;
(a) Name and address of the Architect:
Signature and stamp:
(b) Name and address of the Structural Engineer:
Signature and stamp:
(c) Name and address of the Building Services Engineer:
Signature and stamp:
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(d) Name and address of the Quantity Surveyor:
Signature and stamp:
8. Is the plot affected by any reservation or road lines? If so, are these correctly and
clearly marked on the block plan?
NO
9. What is the actual area available on site: 2034sqm
10. If there is any deduction in the original area of the plot on account of road lines or
reservation (please state the total area of the deductions)
11. If the work is in connection with an industry—
(a) Briefly describe the main and ancillary processes
(b) State the nature and quantum of industrial waste/effluents and
Methods of disposal
NA
NA
12. If the plot abuts two or more streets, information for all streets should be given
13. How many parking spaces are proposed? 12 Cars
14. Are parking spaces for transport vehicles provided? Y
15. Does any natural water course pass through the land under development?
NO
16. Is the plinth level proposed to be the level of the surrounding ground level?
YES
17. Declaration by the applicant:
I declare that the details stated above are true and correct to the best of my knowledge
and belief.
Authorised signature and seal of the applicant
Name: Signature: Seal
Dated this day of, 20
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Attach the following, where applicable—
a) Development permission from the Physical Planning Committee;
b) a boundary opening report from a surveyor;
c) A site plan;
d) Architectural drawings;
e) Services drawings showing locations of proposed and any existing services;
f) Electrical and mechanical engineering drawings showing proposed points of
connection, including lightning protection systems;
g) A site drainage plan;
h) Structural engineering drawings and design calculations for both temporary and
permanent works;
i) Proof of ownership of land in accordance with the Land Act, including the
certificate of title, power of attorney from the registered proprietor or other
satisfactory proof of ownership;
j) A certificate of environmental impact assessment from the National Environment
Management Authority;
k) Building operations and works engineering construction certificate from the
Commissioner of Occupational Safety and Health;
l) A certificate of approval of electrical or mechanical engineering drawings showing
fire detection, protection and fighting by the Police Fire Department;
m) A certificate of approval of change of development by the Physical Planning
Committee;
n) Traffic impact assessment; and
o) Certificate of energy efficiency assessment from the Ministry responsible for
energy.
