Labour Commissioner 
(PRESCRIBED UNDER RULE 3)
APPLICATION FOR PERMISSION TO CONSTRUCT EXTEND OR TAKE INTO USE ANY BUILDING AS A FACTORY
Applicant's Name .....................................................................
Applicant's Calling .....................................................................
Applicant's Address. ....................................................................
Full Name & Postal address of factory .....................................................................
Situation of the factory ....................................................................
Province .....................................................................
District ....................................................................
Town or village .....................................................................
Nearest Police Station .....................................................................
Nearest Railway Station or Steamer Ghat .....................................................................
Particulars of plant to be installed .....................................................................
Signature of Applicant. ....................................................................
Date .....................................................................
NOTE:- THIS APPLICATION SHALL BE ACCOMPANIED BY THE FOLLOWING DOCUMENTS:
(a) A flow chart of the manufacturing process supplemented by a brief description of the process in its various stages;
(b) Plans, in duplicate, drawn to scale, showing :-
(i) the site of the factory and immediate surroundings including adjacent buildings and other structures, roads, drains etc. an
(ii) the plan elevation and necessary cross-sections of the various buildings, indicating all relevant details relating to natural lighting, ventilation and means of escape in case of fire. The plans shall also clearly indicate the position of the plant and machinery aisles and passage ways; and
(c) Such other particulars as the Chief Inspector may require.