FORM Common Application for Consent under Water (Prevention and Control of Pollution) Act, 1974, Air (Prevention and Control of Pollution) Act, 1981 and Authorization under Hazardous Wastes (Management and Handling) Rules, 1989 as amended. No. .......... Accompanying form in triplicate to be submitted by the applicant. One copy may be retained by the applicant. Explanatory note for filling in application form for Consent/Authorization 1. Any applicant knowingly giving incorrect information or suppressing any Information pertaining to any of the items of the application shall be liable for punishment as per provisions under the relevant Act. 2. The application form shall be submitted at the respective Sub - Regional Officer of the Board under whose jurisdiction the applicant‘s activity falls. 3. The application shall be accompanied by the consent fee in the form of Demand Draft in favor of Maharashtra Pollution Control Board. Fee paid is Not refundable 4. For the items marked * strike out which is not relevant 5. If any of the items is not relevant to the activity of the applicant, please state ”Not Applicable‘. 6. If the space for reply provided for any item is inadequate, use additional sheets, duly referenced. 7. Item 1 : Give the name of the person who is authorized by the applicant to transact their business. 8. Item 2 : Also state the concerned instructions under whose administrative area the unit falls. 9. The form shall be accompanied by the relevant documents specified on the last page of the application. 10. Capital Investment -Consent fee is to be paid based on gross block investment of the unit without depreciation till the date of application. The gross block capital investment shall include cost of land, building, plant and machinery without depreciation same shall be certified by Chartered Accountant. In case of proposed unit total project cost shall be considered. Note: The from may be get download from the MPCB Website: http://mpcb.mah.nic.in From fee of Rs.100/- may be added in the current fee in case the downloaded from is used -2PAYMENT OF CONSENT FEES The Fees have been revised vide govt. of Maharashtra, GR dt. 25/08/2011 and are as under; Sr. No. 1 2 3 4 5 6 7 8 9 10 Capital Investment of Industry(including land, building, machinery without depreciation) More than 100 Cores More than 75Crs to 100Crs More than 50 Crs to 75 Crs More than 25 Crs to 50 Crs. More than 10 Crs to 25 Crs More than 5 Crs to 10 Crs More than 1 Crs to 5 Crs More than 60 Lakhs to 1Cr More than 10 Lakhs to 60 Lakhs Below Rs.10Lakhs Consent to Establish Consent to Operate 0.02% of Capital Investment 1,25,000/1,00,000/75,000/50,000/25,000/15,000/5,000/1,500/- 0.02% of Capital Investment 1,25,000/1,00,000/75,000/50,000/25,000/15,000/5,000/1,500/- 500/- 500/- B) Urban Local Bodies ( Under water Act) 1. 2. 3. 4. Municipal Corporation Municipal Council Class-A Municipal Council Class-B Municipal Council Class-C Rs.1,00,000/Rs. 50,000/Rs. 5,000/Rs. 2,000/- “The mining projects will pay Rs.0.40 per tone of Mineral per annum in addition to the payment as per capital cost of the mining project, as consent fee”. Consent fees should be paid by way of Demand Draft drawn in favour of “Maharashtra Pollution Control Board” only. Payable at the HQ of the Concerne Sub-Regional officer. - - * " ' ( + : B 6 # + + <A G 6 ?6 6 B 9 < B 8 9 < 8 + 43 + 2 < 8 " + < @ < & E < <" + 4/) <" * * E 2 H < < + + <( @ < .& 0 + ! <= < # < 7 8 71 7 8 0 <B ' + @ 8 ' 0 < 6 <: B ' < $ ;& + 0 ( @ : ' < E 2 <: B A + 555+ 35 & A 7B 2 434+ < - 0 7B 6 7: 0 -.- & 7 8 7 8 <& I 0 0 0 + 1 + + 8 < 76 7 " 5<! + 6 7 8+ 8 =& ! <E & < + " . 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