1.

  Applicant/Institution Name 

:

2.

  Full Address
  Place               :
  Taluk               :
  Town               :
  P.C. No.          :
  Post Office      :
  District            :

:

3.

Does the applicant belong to SC/ST?

4.

Where is the water pumping windmill to be installed?

(Extent of land survey No. and details of place should be furnished)

(Photo copy of the document to prove the ownership of the land should also be enclosed)
  Survey No.     :
  Place            :
  Taluk            :
 

5.

Purpose for which the windmill  has to be installed ?
a. Minor irrigation/ drinking water/ other reasons
b. Extent of area used for minor irrigation (in acres)

6.

Is there good wind speed during the major period of year?  

7.

a. Details of availability of water resources

   (for water pumping)   
 

 Dugwell                         Borewell 

 Diameter of the well        Borewell diameter

 and its depth                  and its depth

b. Tank/River-Details of Availability of water 

c. Depth of water level from ground level  
      In winter ..............................ft/meter
      In summer ...........................ft/meter

8.

Details of electric loads required to be fed (for small aerogenerators)

Type of Load         Number         Total Watts     No. of hours to be used

(a)  Lights

(b)  Fans

(c)  Any other

      equipment

9..

Is there any obstruction in and around the place where the windmill has to be installed?
(Tall buildings, telephone/electricity posts and tall trees around 100 metres)  

10.

a. Will you take full responsibility after the installation of  windmill?                                                                 
b. Will you bear the expenditure on operation and maintenance of  windmill?                                              

Yes /No

Yes /No

11.

Do you agree to depute any of your representatives toTEDA for training on the operation and maintenance  of the Windmill?   

Yes/No

12.

Will you accept to insure the wind mill ?                            

Yes/No

13.

a. Do you agree to bear the balance cost of the windmill after subsidy? 
b. Will you pay Rs.5000/-  for water pump and Rs. 8,000/- for aerogenerator towards Caution Deposit of our application?
(If yes enclose a DD in favour of TEDA furnish details)
   Number          :
   Date              :
   Value of DD    :

Yes/ No

Yes/No

14.

You have to bear the expenditure on civil foundation. Iron bridge to hold the Iron pillars of the windmill, additional pipelines, additional pump rods etc.
 

We agree to pay the DD in favour of TEDA and also agree to complete the work.

15.

On receipt of the application, it will be sent to the MNRE for sanction. If it is not sanctioned by the MNRE, the caution deposit amount will be refunded. After receipt of the final allotment order the windmill has to be installed by the beneficiary immediately. 

If not the caution deposit amount will not be refunded.
 

After installation of the windmill the caution deposit amount will be directly released to the supplier who collects his charges from beneficiary after deducting subsidy and caution deposit.
 

Will you agree to this?

Yes/No

16.

  If necessary, will you construct storage tank at your cost?
  
  Address for correspondence:  
  Place              :
  Post Office      :
  Taluk              :
  District           :
  Telephone No. :
  PIN Code        : 

Yes/No

  Date of Inspection

  Is the place suitable for installation of windmill?                        Yes/No  

  If yes, have you received DD from the applicant?                       Yes/No
  Details of DD   :           Number            :
                                    Date                 :
                                    Amount            :   Rs.

  If not, reasons         :
  
  Signature                :
  Name of Institution   :
  Address                  :
  Name and date        :