SEARCH
Philippine Government Forms All in One Location
Tweet
Share
Application for Clearance to Develop
PPA application form for clearance to develop private ports
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Tracking No. ____________
APPLICATION FOR CLEARANCE TO DEVELOP
APPLICANT PROFILE
Name of Applicant/Company:
Name of Authorized Representative:
Address 1 (Office Address)
Telephone Number 1:
Address 2 (Billing Address):
Telephone Number 1:
E-Mail Address:
Fax Number
Tax Identification Number (TIN)
SEC Registration Number
Business Type:
Single Proprietorship
Partnership
BDT No.
Corporation
Nature of Business:
PRIVATE PORT PROFILE
Port Facility/Structure to be Put-Up:
Wharf
Estimated Cost of Improvements to be Put-Up:
Location/Site of Private Port:
Barangay _____________________
Foreshore Lease Contract No.
Area size (in sq.m.)
Environmental Compliance Certificate (ECC) No.
Pier
Others
Intended use/purpose:
Municipality/City of
_________________________
TCT No. (Back-Up Area)
Duration/Term of Permit: No. Of Mos. ____
DOCUMENTARY CHECKLIST
No. Of Yrs. ______
VALIDATION FOR PPA USE ONLY
(Put () if submitted, (x) is not available)
Basic Requirements:
Filing Fee
Unified Application Form specifying the exact location of the
foreshore area, area size in sq.m., intended use/purpose,
Date of Filing:
proposed structure to be put-up and estimated cost of
O.R. No.
improvements with Summary of Project Scope, Description
and Vicinity Map as attachments
Received by:
Duly Notarized Omnibus Undertaking (Sworn Affidavit)
Printed Name and Signature
Remarks:
Status as of _______________________
Approved
Denied
Pending
