Application for quarry lease - Jharsuguda

FOR MINOR MINERALS
FORM-15
APPLICATION FOR QUARRY LEASE
(See Rule.5)
To
..................................................................
Dated the 200...
Sir,
1. I/We submit an application for a quarry lease of...................(minerals) a term of................
years over..................hectares of land in the area specified in the Annexure given below.......................
2.A sum of Rs.2000/- payable as fee for the grant of such lease under rule 6 of the Orissa Minor
Mineral Concession Rules,1990 has been paid in the Government Treasury at.........................and the
receipted challan is enclosed.
3.The required particulars are given below:-
(I)
(ii)
(iii)
(iv)
Name and address of the applicant............................................
Nationality of the applicant.....................................................
Profession of the applicant.....................................................
Approximate quantity of minor minerals expected to be
raised annually.......................................
(v)
Particulars of the areas mineral wise within the State for which the
applicant or any person jointly interest with him................................
(a)
(b)
(c)
(d)
Already holds a quarry lease.......................
has already applied for quarry lease but not granted.............
being applied for simultaneously.....................................
nature of joint interest, if any.........................................
(vi)
Means by which the Minor Mineral/Minerals is /are to be raised, i.e.
whether manual or mechanical.....................................

(vii) Manner in which the minor mineral raised is to be utilised.
(a)
(b)
(c)
for manufacture....................................
for sale................................................
any other purpose................................
(viii)
(ix)
(x)
(xi)
(xii)
(xiii)
(xiv)
Details of the plan of the area applied for to be enclosed:-
(The plan should be on the relevant portion of the cadastral village
map with scale and should contain natural features , land marks or
other features to enable identification of the area in the field , the
nearest railway stations, or any other places of importance)
Has the applicant any previous experience in quarrying:
If yes, details should be given ................................................
Financial resources of the applicant.............................
Total investment in the operation anticipated.......................
Particulars of the receipted Treasury Challan for the fee.................
Attested copies of I.T.C.C. and S.T.C.C. of the last financial year and
valid on the date of application...........................................
Any other particulars which the applicant wishes to furnish..................
1.Name of the Village/Forest Block
2.Details of the area applied for in each Survey Number
3.Full description of the area applied for with regard to natural
features..............................
4.District
I/We hereby declare that the particulars furnished above are correct and undertake
to furnish any other details, plan, etc.,as may be required by you.
PLACE:-
Yours faithfully,
DARE:
Signature of the Applicant.
N.B.: If the application is signed by an authorised agent of the applicant, the power of attorney should
be attached.