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Form-4

APPLICATION FOR AMENDMENT IN ENVIRONMENTAL CLEARANCE

(To be filled up by User Agency)

1.	Details of Project

Proposal No. : SIA/TN/MIS/307980/2024
(a) Name of the project : Proposed Construction of Commercial building RSM Tower at Devathanam Village, Trichy
(b) Name of Company / Organisation. : RSM TOWER
(c) Registered Address. : 45, NSB road Tamil Nadu 620002
(d) Legal Status of the Company. : Private
(e) Joint Venture (Yes/No) : No

2.	Address for the Correspondence

(a) Name of the Applicant. : roshan manavalan
(b) Designation (Owner/Partner/CEO) : partner
(c) Address :-
       State : Tamil Nadu
       District : Tiruchirappalli
       Town / Village : No
(d) Pin Code : 620002
(e) Email : ro_shantoall@yahoo.com
(f) Telephone no : No
(g) Fax no : No
(h) Mobile no : 9894227555
(i) Contact Person. : roshan
(j) Website (if any) : No

3.	Category of the Project/Activity as per Schedule of EIA Notification,2006

(a). Major Activity. : 8(a) Building and Construction projects

      Minor Activity : No
      Major Sub Activity. : No
      Minor Sub Activity : No
(b). Category : B2
      Reason for applicant at central level/state level(in case of B1 and B2 ): No
(c). Reason : No
      EAC Concerned (for category A Projects Only ): No

4.	Location of the Project

(a) Plot No/Survey No/Khasra No : 4/6, 4/7, 4/8 & 10/6
(b) Village : Devathanam village
(c) Tehsil : Tiruchirappalli
(d) District : Tiruchirappalli
(e) State : Tamil Nadu
(f) Pin Code : 620002
(g) Bounded Latitudes (North) : Yes
        From : Degree:10, Minutes : 50, Seconds :1
        To    : Degree:10, Minutes : 50, Seconds :5
(h) Bounded Longitudes (East) : Yes
        From : Degree:78, Minutes : 42, Seconds :28
        To    : Degree:78, Minutes : 42, Seconds :30
(i) Survey of India Topo Sheet No : 58J

5	Details of Environmental Clearance

(a) Project Name : Proposed Construction of Commercial building RSM Tower at Devathanam Village, Trichy
(b) MoEF&CC / SEIAA File No : SW/183972/2020
(c) Date of issue of EC : 27/04/2021 (d) Uploaded EC letter :

6	Details of Consent to Operate

(i) Whether Consent to operate obtained (Yes/No) ? : No

7	Amendment Sought for

Amendment in Configuration/ Amendments in Clearance condition/ Other (specify) : Configuration change. Utility Area location changed

8	Details of Product (as per the approved EC)

Details of Products
S.no	Product / Activity (Capacity/ Area).	Quantity	Unit	Mode of Transport/ Transmission of Product
1	Built up area	28093.17	Others	Others

9	Details of Configuration (Multiple Entries Allowed)

Details of Configurations
S.no	Plant/ Equipment/ Facility	Existing Configuration	Proposed Configuration	Final configuration after Amendment	Remarks if Any
1	Built up area	28093.17	1386.42	29479.59	Utilities planned in the terrace floor is planned in a new separate building at the corner of the pl

10	Reasons for Amendment

Reasons for Amendment : Change in the Location of Utility Building. No increase in pollution load and other parameters. Area increased due to DG building planned in terrace of the tower is separated and proposed in new location.

11	Any Other Amendment required

Any Other Amendment Required
S.no	Reference of Approved EC	Description as per Approved EC	Description as per Proposal.	Remarks
1	6 Built up area	28093.17	29479.59	Area increased due to change in the location of ut

12	Details of EIA Consultant

Have you hired Consultant for preparing document (Yes/No) ? : Yes
(i) Accereditation No : NABET/EIA/2225/IA 0100
(ii) Name of EIA Consultant : IFluids Engineering
(iii)Address : Shenoy Nagr chennai
(iv)Mobile No: 9952936856
(v)Landline No : 9952936856
(vi)E-mail Id : krishnan.vijayalakshmi@gmail.com
(vii)Category of Accreditation : B
(viii)Sector of Accreditation : 38
(ix)Validity of Accreditation : 21.07.2025 (x)Uploaded certificate of Accreditation certified by QCI/NABET :

13.	Documents to be Attached

(a) Uploaded addendum to EIA/EMP Report:

(b) Uploaded Copy of revised -Feasibility Report /Detailed Project Report (DPR) / Detailed Engineering Report / Detailed Conceptual Plan / Approved Mining Plan (in case of mining proposals):

(c) Uploaded Copy of final Layout Plan:

(d)Uploaded Cover Letter duly signed by the project proponent or authorized person:

(e)Uploaded a copy of authorization duly signed by the project proponent in support of the person making this application on behalf of the User Agency:

(f)Uploaded Additional File, If any : No Data

Essential Details Sought

Essential Details Sought
S.no.	EDS Sought Date	EDS Sought	Letter
NIL

Additional Detail Sought: NIL

14.	Undertaking

(a): I hereby give undertaking that the data and information given in the application and enclosures are true to be best of my knowledge and belief and I am aware that if any part of the data and information found to be false or misleading at any stage, The project will be rejected and clearance given, If any to the project will be revoked at our risk and cost. In addition to above, I hereby give undertaking that no activity / construction / expansion has since been taken up. (b)Name : roshan manavalan (c)Designation: partner (d)Company: RSM TOWER (e)Address: 45, NSB road Tamil Nadu 620002