DearApplicant Thankyou forthe interestshown in developing renewable energy resources in Sri Lanka_ We are pleased to present you a copy ofthe prescribed applicauon form attached hereto, formulated according to the provisionslaidoutinthesriLankasustainableEnergyAuthorityActNo.35of2ooT,ongridRenewableEne€yprojects Regulation 2009 published in the Gazette No. 1599/6 of 27th Aprit 2009 and amended by the Gazett e No. r'tos/2z ol 10th lvlay 2011. A Guide to the P.oject Approval process for on-grld Renewable Energy project Development (version v2.0/2071) can be downloaded at http://wwwenergy.govlk/pdf/guide ine/crid,Renewable.pdf you are strongty advised to go through thls Guide before submjtting yourapplication. Your kind attention is invlted to cha pter 2.0'Applying for a provisional Approval'given in the Guide to the project Approval Process, for detai s on submitting a complete app ication. please be kind enough to pay the application fee either in cash or through a bank draft, since this Authority is not in a position to accept cheques forrhe payment of application fees. We lookforward tothe perfected application form. ThankYou DirectorGeneral Method of Submitting New Applications Any person, an individualor a company, may apply to develop a renewab e energy pfoject anytime, irrespective ofwhetherthepersonholdsanyrightstoiheresourceorlandrrghts.'fhesEAwouldentertainonrycomprete appicationsasrequiredunderSectionl6(2)oftheAct.Acornpeteapplicationform,prescfbedintheOngrid Renewable Energy Projects Regu aron 2011, accompanied by a pre-feasibirity feport prepared by a consurtant accredited bythe Authority, dea ing w th the fol owing rna n cornponents the prescribed application fee tothe SEA. a) b) L' d) e) f) g) h) w l have to be made after pavment of PrefeasibilityreportpreparedbyaConsultantaccreclitedbySEA,withtheonepaBe5ummary ofthe map ofthe geographicallocation ofthe prooosed Droiect A b ef oe.( r ipr'on or the o.o or I. i-ci-o I Ir1e a-nounro, pow;.t;Deeenerated Thetotalestimatedcostandfinancialmodel ncudngtheoptimisatro;critenaadoptecr Proof of availabrrity of adequate finances or the manner in which the requrred finances for the prorect are to be obtained Project location, describing the relative location of energy conversion plant and equ pment to the resource/ as a further explanation of (b)above A staternent explalning how the appl cant intends to dellver e ectrlclty generated by the project to the nationalgrid, and geographicalarea traversed bythe power inetobeconstructedforthatpuroose A copy of the receipt obtained from the SEA, for ihe payment of the pr€scribed appltcat on fee, which wil be calculated according totable below. A copy Amount ot power proposed to be generated Fee to be paid on application 1,000 kW of part thereof LKR 100,000 E:ch add t onal 1,000 f,W LKR , v^fT 50,000 payable on pro rata basis Note: Prajects aJ copdcities ress than 10,o0akw inplemented byosinqrepaftyorpdrtiesacting pnoses tn d some geasraphicar ar spatior context wi in cancert, rn t)ord eiar in be considercd os d sinqle praject capabte aJ seneratins mare thdn Any app ication, after an nitial inspection having obvious omlssions wi I be feturneo unregrstered to the Appicant,requestingtheattentiontothesaidomisslons.AnApplicantwhofaj tosubmitcompleteaDDlicatjon forms runs the risk of another party appry ng for the same resource srte, beiween the first attempt to submit the applicatlon and the second attempt, after attending to the obvious omissions as pointed out by the sEA. APPLICATION FORM Date ofApp ication lttl Registration No. R For official use only Application for Ensaging in and Carrying on ofan on-srid Renewabte Energy proj€ct For pfolects ofrhe Epc t5ted be ow see "Guide to the Proj€ct approva processforon-GridRenewabeEnergyDeveopment"fortheporicyonothertypesof renewabt€ energy projects I 1. Project Type: Please mark in the appfopriate box be Hydro Biomass (Grown) 2. Name ofthe Project and its Capacity (kW):. Sma I (This is on y for identification, 3. Name and Address Name: (MrlMs./ ow Agricultura ptease setect ontv one tvpe. Induskial the egal name may be establlshed ofthe Applicant l\,4 u n icipal Heat Oth6f at a later stage) i ............ ) lf the applicant is a Company Name ReBistratlon No . . Names of Directors of the Company Addressi Telephone Numbers 0 0 companv reso ution ce,tified bv companv secretafy arthor srng the applicant to sLrbmit the app icat on (prease attach) Project Pre-feasibility/Report (please attach) The Applicant is expected to provide a Pre-feasibility report along with the application prepared bv a Consultantaccredited bytheAuthority, includingthe info.mation and documents referred to jn paragraphs (a) to (f) of a, su b-section {2)Section 16oftheAct. Paste in the box below the relevant part copyofl:50000 M:pwith P.oject Layort ofthe 1:50000 map showing locations ofthe all projecr componenrs {1:5O0OOscate notto beattercd) (b) a brief description of the project, inc uding the amount of power to be generated; Projeat Information In Project Type: ir odGe.erdt_B(dpa yofrLeP"rr( n, l3|ri. r.1 Str.anr/ni\r!r I f Flylrcl Annua Electricity Generation (cWh) Proposecl location ofthe Power Plant: provide the details b€tow Vi agelcr:ma Niladhafi Divlslon Divisiona Secretary Divlslon D str ct (c)the tota estimated cost and financial model, including optlmisation criteria adopted; (d) proof of avallabi ity of adequate finances or the manner ln whlch the required finances for the project are to be obtained; lve I aNC Povrer l-1ouse ie :tl!€ tc I vEr oi sifeam sysiem if i ls a hydfo pc\,\re - picjeci, wind TurbineandStructuresifitlsaWindpowerproject,!ne.,syPl.ntatlcn.pc\rert-tou5eand$,/eter-Sour.elftisa Biornass prol cc,t and Conversion facillty rE ail!e tc erergy fesoLrfc-6, rl it i5 any oihef proje.t;and {e) Project location Le. (f) Grid connect on /.e. how the applicant intends to evacuate electricity generated and the point at which the generator will be connected to the national grid and the geographical area traversed by the power line constructed for th s purpose_ Certification by the Applicant: herebycertifythatthePfefeaslbilityR€portattachedtothtsappticationh:sbe€npreparectbv (nanre), a Con5Lrltant accredited by ihe Authorit, and whore name and signature appears on page l ofthe Repod. I attach hefewith a copy ofthe receipt obtatned, on the payment of the appropriate fee which is reqLrtred to be made along with this application. lattach herewith technicaland otherdeta re ated to the resoufc€ site, as requened by the Dtrector cenera lhave read and understood the "cuide tothe ProjectApprova Processforon-Grid Ren€wab e EnersyDeve opment,, ls Nanre of person signing this app cation:. Date Signaturel CALCULATION OF APPLICATION FEE Column I Amount ofpower proposed to be gen€rated Column additional 1,000 kW ! Fe€ to b€ paid on application and reapplication 1,000 kW or pan thereof Each ll LKR LKR 100,000 50,000 pay.ble on pro rata basis Nore. Projects ofcopacities lessthon 10,0A0 kW implenented by o sinqle porty or pdrtiesocting in conceft, jn parollelor in phdses in o same geogrophicol or spatial context will be considercd as a single prcject copable of generating nore thon 1o,aoA kWofpower. h I Checklist of Contents of the pre feasibt ity Study which is to be attachecl to the Apptication for Provisional Approvalfor an On-grid Renewab e Energy project Profile of the Applicant Mark Yes N"T e o[ lhe v ,ldee and Slerch o'thp dre. r La dorint .rdri\6 o \ sor "a'rd..po o. r-p ptoie(. vr Ln nd ownersh p inforrnatlon Current land use and socio econornic background in the area General Infrastructure facilities access foads, n€arest CEB grid substation Wind Resource Analysis Descript on of the loca w nd c imate '5tinared dv"'Jge drrudlwind rpeed/ al t,le ,ire Est mated Weibul pararr1eters L(lrrdted v\ind soFpd, lraque-cy cl\.. bLr on Preliminary Plant Design Rated capaclty Wind turbine speclfications and power curve clata Prellminary plant layout including a sing e f ne dfagru. of tn" Interconnection, -Hropo9eo JJ tv "l".trl.ul ,y.t"rn up to grid tran9mtss on llne route . Lros( d'r'r,! e e-t', ge.er"t,o-. o,,ej ne .drF. o th6 g. o Transport of wind turbines proposed foute, identifted bottieneck (.anereoLi -Tenl .lo-"'" t,o-o * -o . .,b ,,", .tv Environmental Considerations Localised social & environmenta benefits itKe y ro resuh due to the proposed project ocd.(-d -agdli.e .o, " & F-v.o rr en_a npdct( like y to result due to the project Proposed measures to mitigate negative impacrs Project Costs Capitalcosts O&M costs, nsurance costs FinancialAnalysis Financing para meters Financial analysis includlng a sensitivity analysis agalnst ley var ab es Project Development plan Site ownership, plans to acquire land Source(s) earmarked to raise the equitv and debt financing Prolect implementation schedule ' cLrrfent bLrsiness, products,/services, propos€d business ptan for the project _ AnnLral Av€rage Wind 5p-.ed ( ) No (x) Annex to the Pre-feasibility Report: Land ResoLrrce Requjrements For Project Components Extent Location/Oescription Present Ownership t For Site Access Extent ,t 1., tocation/Description Present Ownership .9 3 9 c E E t j '- j -6 € ! z 6 E E d t li 3 : ol ,9 t: = t: o 'lT l.! 3 ': a e ; .= = t.: :E .9 c.9 E z ; :E a! E <'. -9 9 ! e 5 l e .9 E E ,a E ; E '6 = 6 E ! -= .g l; .= l; ! .= 3 E 6 = p I 'a t; t: ;, 6 7 o j ! E q E E -9 .9 ,=J i 5l I] ! 2 ;i el d * I 3l 9 : ; i- e:- E 3 ll t-* ,q l= ii :E .= E H E ,i ; E I I 3 .= 3 .9 E E ; ! f E z E i E 3 ;d3 4 E I i Checklist of important attributes to be considered when registering new applications Duly filled application form [r]nute by D r/Head fof process ng oiappicaton Prolecllj'pe Nme ol Prorecl & ls Capacly Contaci delais Name olApp .ant llthe appi.aft s ro be changed tarerfor any reason a process ng ree equarto applcato. is reql €d lo be pa d. lo effecl such changes Prejeas blty report F@pared by a Co.su tanl ac.red ted by SEA 4(.) .1(d) s Origirdl ."o. "ol , Lor atron lva leo A breidescrpion olthe prolecl The 1o1a est mated cosl and Tc rr ore.r." pw n. ina.ra rap O0l]O. mod; r,re 991!s!qt4E1qq!9 tir.o,," cenircato. by theAqcred ted consutl. Pre Feas blty Study.over page p-1""rtyp" l cacact{ \4! qtg!!!!E rppi"nnto"r"r" l - J c.".,tnnr o"r" o15-Pe Summa4 sheei Form.tF2 "[f ^,," Annual Reporls / Aud ied Accounls r Acopy orlhe recept obta ned trom rhe SE^ lo lhe p.\mentofnppKalon ree Reasons of Refusal of Application r Any Conf ict with Marked location with respect to SEA Maps of EnerGlS interface Over / lJnder est mation of Power Capactty Non avai ability of Concurrence of CEB to grid connect the proposed p.oject when consu ted !ncler the provlsions of Section 17 of the Act. f particular NRE resources is earnrarked ear ier or is to be cleve oped by a state sector organ sat on Capacity gfeater than 10MW; which carries no wrltten direct ve from the M nistry of power and Enefgy speciflc to the project Project located nanExcudedArea: al natufal reserves, such asConservaton ForestsandWild Life Sanctuaries and other se ns tlve a reas Notel . r r On y the comp ete appllcat ons as requlred under the Section 16{2) of the Act of SLSEA and further prescrlbed in the on grid Renewab e Energy projects Regu ation 2011 wiri be enterta necr by sEA. The ava abi ty of a particulaf resources ocation can be checked by oggtng on to the Enercls database through (httpi//wwwenergy.govlk/sub_pgs/geographic.hrm ) or by perusing the maps provided at the Tront ollrre ot \t A Pre leas billty report should nc ude a the tems in the checklist Format F1 Certification by Applicantl I have read, ver fied and understood that thls appltcat on is complete / incornplete in terms of the sec|on 1G of the Sri Lanka Sustalnab e Energy Authority act No.35 of 2007 and take responsibl ity for the acceptance of the app ication based on the fact5 contained therein / the rejection of the app cation by the project Approv ng Cornmittee on any one or more grounos Trenr oneo above Date: App icant name and signaturel Time: Witnessed by SEA officer name &