Form BCA-BE-STAPPV01-RW This form may take you 5 minutes to complete. THE BUILDING CONTROL ACT DECLARATION BY A QUALIFIED PERSON FOR STRUCTURAL WORKS FOR THE APPROVAL OF STRUCTURAL PLAN (RETAINING WALL) Commissioner of Building Control Building and Construction Authority 52 Jurong Gateway Road, #11-01 Singapore 608550 FOR OFFICIAL USE Project Ref. No.:____________________________________ INSTRUCTIONS 1 * Delete accordingly 2 Please use BLACK INK to complete the form Project Title:__________________________________________________________________________________________________ ____________________________________________________________________________________________________________ *Lot/Plot: ________________________________________________________________________ *TS/MK: ___________________ House No. _______________Road: _______________________________________________________________________________ 1 I, _________________________________________, the qualified person for structural works appointed under Section 8(1)(a) or 11(1)(d)(i) of the Building Control Act, hereby certify that the building plans for the above proposal and the building works shown therein are generally in accordance with the said Act and the building regulations, particularly with the applicable standard requirements which I have ticked [√] and counter-signed in the schedule hereto. 2 I certify that the proposed retaining wall (s) :a) b) c) *do / do not affect the public sewer or involve new connection to sewer ; *do / do not encroach on any Drainage Reserve ; and *do / do not encroach on any Road Reserve as evidence by the copy of SIP, DIP and RIP attached to this submission. Note:If any of the items listed in 2(a), 2(b) or 2(c) is affected, then a copy of the clearance letter from the relevant technical departments must be submitted. 3 I certify that a copy of the Form BEV/A1_RW_ Appendix 1 has been forward to the Director, Catchments & Waterways Department, Public Utilities Board. 4 I confirm that the exposed height and setback of the retaining wall are in compliance with the approved plans issued by the Competent Authority under the Planning Act (Cap 232) for DC ___________________________ dated ____________________. Stamp & Signature of Qualified Person for Structural Works: Name & Address of Professional Firm: Date: UEN: BEV/A1_RW_Dec 2009 Tel no.: Page 1 of 2 To: Director Catchments & Waterways Department Public Utilities Board 40 Scotts Road #07-00 Environment Building Singapore 228231 Project Ref. No.: _______________________ PROPOSED ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ I, ____________________________, Registration No.____________, the qualified person for structural works appointed under Section 8(1)(a) or 11(1)(d)(i) of the Building Control Act (Cap 29), hereby certify that I have noted the following drainage requirements and I undertake to ensure that these requirements will be complied with in connection with the retaining wall proposal:- a) The retaining wall proposal will not in any way affect the drainage of the site or the adjacent areas; and b) The retaining wall will not induce loadings on or in any way adversely affect any drainage structures or drainage reserves. _________________________________________ Signature and Name of Qualified Person for Structural Works BEV/A1_RW_ Appendix 1_Dec 2009 _______________ Date Page 1 of 2