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Application for Outline Planning Permission with all matters reserved.
Town and Country Planning Act 1990
You can complete and submit this form electronically via the Planning Portal by visiting www.planningportal.gov.uk/apply
Publication of applications on planning authority websites
Please note that the information provided on this application form and in supporting documents may be published on the
Authority’s website. If you require any further clarification, please contact the Authority’s planning department.
Please complete using block capitals and black ink.
It is important that you read the accompanying guidance notes as incorrect completion will delay the processing of your application.
1. Applicant Name and Address
Title: First name:
Last name:
Address 1:
Address 2:
Town:
Address 3:
County:
Country:
Postcode:
Company
(optional):
House
number:
House
name:
House
suffix:
Unit:
2. Agent Name and Address
Title:
House
name:
House
suffix:
House
number:
Unit:
Company
(optional):
First name:
Last name:
Address 1:
Address 2:
Town:
Address 3:
County:
Country:
Postcode:
3. Description of the Proposal
Please describe the proposal:
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3. Description of the Proposal (continued)
Has building or works already been
carried out?
No
Yes
If Yes, please state the date when building
or works were started (DD/MM/YYYY):
(date must be pre-application submission)
Have the works been completed?
NoYes
If Yes, please state when the works were
completed (DD/MM/YYYY):
(date must be pre-application submission)
4. Site Address Details
Please provide the full postal address of the application site.
House
name:
House
suffix:
House
number:
Unit:
Address 1:
Address 2:
Town:
Address 3:
County:
Postcode
(optional):
Easting: Northing:
Description of location or a grid reference.
(must be completed if postcode is not known):
Description:
5. Assessment of Flood Risk
Is the site within an area at risk of flooding? (Refer to the
Environment Agency's Flood Map showing flood zones 2 and 3 and
consult Environment Agency standing advice and your local
planning authority requirements for information as necessary.)
Yes
No
If yes, you will need to submit a Flood Risk Assessment to consider
the risk to the proposed site.
Is your proposal within 20 metres of a
watercourse (e.g. river, stream or beck)?
NoYes
Will the proposal increase
the flood risk elsewhere?
Yes
No
How will surface water be disposed of?
Sustainable drainage system
Soakaway
Main sewer
Existing watercourse
Pond/lake
6. Pre-application Advice
Has assistance or prior advice been sought from the local
authority about this application?
No
Yes
If Yes, please complete the following information about the advice
you were given. (This will help the authority to deal with this
application more efficiently).
Please tick if the full contact details are not
known, and then complete as much as possible:
Officer name:
Reference:
Date (DD/MM/YYYY):
(must be pre-application submission)
Details of pre-application advice received?
7. Authority Employee / Member
With respect to the Authority, I am:
(a) a member of staff
(b) an elected member
(c) related to a member of staff
(d) related to an elected member
Do any of these statements apply to you?
Yes No
If Yes, please provide details of the name, relationship and role
Please state the site area in hectares (ha)
8. Site Area
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9. Residential Units (Including Conversion)
Does your proposal include the gain, loss or change of use of residential units?
If Yes, please complete details of the changes in the tables below:
Yes No
TOTAL NET GAIN or LOSS of RESIDENTIAL UNITS (Proposed Housing Grand Total - Existing Housing Grand Total):
Market
Housing
Not
known
Number of Bedrooms
Total
1 2 3 4+ Unknown
Houses a
Flats and maisonettes b
Live-work units c
Cluster flats d
Sheltered housing e
Bedsit/studios f
Unknown type g
Totals (a + b + c + d + e + f + g) = A
Social Rented
Not
known
Number of Bedrooms
Total
1 2 3 4+ Unknown
Houses a
Flats and maisonettes b
Live-work units c
Cluster flats d
Sheltered housing e
Bedsit/studios f
Unknown type g
Totals (a + b + c + d + e + f + g) = B
Intermediate
Not
known
Number of Bedrooms
Total
1 2 3 4+ Unknown
Houses a
Flats and maisonettes b
Live-work units c
Cluster flats d
Sheltered housing e
Bedsit/studios f
Unknown type g
Totals (a + b + c + d + e + f + g) = C
Key worker
Not
known
Number of Bedrooms
Total
1 2 3 4+ Unknown
Houses a
Flats and maisonettes b
Live-work units c
Cluster flats d
Sheltered housing e
Bedsit/studios f
Unknown type g
Totals (a + b + c + d + e + f + g) = D
Total proposed residential units (A + B + C + D) =
Proposed Housing
Market
Housing
Not
known
Number of Bedrooms Total
1 2 3 4+ Unknown
Houses a
Flats and maisonettes b
Live-work units c
Cluster flats d
Sheltered housing e
Bedsit/studios f
Unknown type g
Totals (a + b + c + d + e + f + g) = E
Social Rented
Not
known
Number of Bedrooms
Total
1 2 3 4+ Unknown
Houses a
Flats and maisonettes b
Live-work units c
Cluster flats d
Sheltered housing e
Bedsit/studios f
Unknown type g
Totals (a + b + c + d + e + f + g) = F
Intermediate
Not
known
Number of Bedrooms
Total
1 2 3 4+ Unknown
Houses a
Flats and maisonettes b
Live-work units c
Cluster flats d
Sheltered housing e
Bedsit/studios f
Unknown type g
Totals (a + b + c + d + e + f + g) = G
Key worker
Not
known
Number of Bedrooms
Total
1 2 3 4+ Unknown
Houses a
Flats and maisonettes b
Live-work units c
Cluster flats d
Sheltered housing e
Bedsit/studios f
Unknown type g
Totals (a + b + c + d + e + f + g) = H
Total existing residential units (E + F + G + H) =
Existing Housing
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10. All Types of Development: Non-residential Floorspace
Does your proposal involve the loss, gain or change of use of non-residential floorspace?
Yes No
Unknown
If you have answered Yes to the question above please add details in the following table:
Use class/type of use
Not
applicable
Existing gross
internal
floorspace
(square metres)
Gross internal floorspace
to be lost by change of
use or demolition
(square metres)
Unknown
Total gross internal
floorspace proposed
(including change of
use)(square metres)
Unknown
Net additional gross
internal floorspace
following development
(square metres)
A1 Shops
Net tradable area:
A2
Financial and
professional services
A3 Restaurants and cafes
A4 Drinking establishments
A5 Hot food takeaways
B1 (a) Office (other than A2)
B1 (b)
Research and
development
B1 (c) Light industrial
B2 General industrial
B8 Storage or distribution
C1
Hotels and halls of
residence
C2 Residential institutions
D1
Non-residential
institutions
D2 Assembly and leisure
OTHER
Please
Specify
Total
In addition, for hotels, residential institutions and hostels, please additionally indicate the loss or gain of rooms
Use
class
Type of use
Not
applicable
Existing rooms to be lost by
change of use or demolition
Unknown
Total rooms proposed
(including changes of use)
Unknown
Net additional rooms
C1 Hotels
C2
Residential
Institutions
OTHER
Please
Specify
11. Employment
Please complete the following information regarding employees:
Full-time Part-time
Total full-time
equivalent
Existing employees
Proposed employees
12. Hours of Opening
If known, please state the hours of opening (e.g. 15:30) for each non-residential use proposed:
Use Monday to Friday Saturday
Sunday and
Bank Holidays
Not known
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13. Industrial or Commercial Processes and Machinery
Not
applicable
The total capacity of the void in cubic
metres, including engineering
surcharge and making no allowance for
cover or restoration material (or tonnes
if solid waste or litres if liquid waste)
Unknown
Maximum annual
operational through
put in tonnes (or litres if
liquid waste)
Unknown
Inert landfill
Non-hazardous landfill
Hazardous landfill
Energy from waste incineration
Other incineration
Landfill gas generation plant
Pyrolysis/gasification
Metal recycling site
Transfer stations
Material recovery/recycling facilities (MRFs)
Household civic amenity sites
Open windrow composting
In-vessel composting
Anaerobic digestion
Any combined mechanical, biological and/
or thermal treatment (MBT)
Sewage treatment works
Other treatment
Recycling facilities construction, demolition
and excavation waste
Storage of waste
Other waste management
Other developments
Please describe the activities and processes which would
be carried out on the site and the end products including
plant, ventilation or air conditioning. Please include the
type of machinery which may be installed on site:
If the answer is Yes, please complete the following table:
Is the proposal a waste management development?
Yes
No Unknown
Please provide the maximum annual operational throughput of the following waste streams:
Municipal
Construction, demolition and excavation
Commercial and industrial
Hazardous
If this is a landfill application you will need to provide further information before your application can be determined. Your waste
planning authority should make clear what information it requires on its website.
14. Existing Use
Please describe the current use of the site:
Is the site currently vacant?
Yes
No
If Yes, please describe the last use of the site:
When did this use end (if known)? DD/MM/YYYY
Does the proposal involve any of the following?
If yes, you will need to submit an appropriate contamination assessment with your application.
Land which is known to be contaminated?
Yes No
Land where contamination is suspected for all or part of the site?
Yes No
A proposed use that would be particularly vulnerable to the presence of contamination?
Yes No
(date where known may be approximate)
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15. Ownership Certificates and Agricultural Land Declaration
One Certificate A, B, C, or D, must be completed with this application form
CERTIFICATE OF OWNERSHIP - CERTIFICATE A
Town and Country Planning (Development Management Procedure) (England) Order 2015 Certificate under Article 14
I certify/The applicant certifies that on the day 21 days before the date of this application nobody except myself/ the applicant was the
owner* of any part of the land or building to which the application relates, and that none of the land to which the application relates is, or
is part of, an agricultural holding**
NOTE: You should sign Certificate B, C or D, as appropriate, if you are the sole owner of the land or building to which the
application relates but the land is, or is part of, an agricultural holding.
* “owner” is a person with a freehold interest or leasehold interest with at least 7 years left to run.
** “agricultural holding” has the meaning given by reference to the definition of “agricultural tenant” in section 65(8) of the Act.
Signed - Applicant: Or signed - Agent: Date (DD/MM/YYYY):
CERTIFICATE OF OWNERSHIP - CERTIFICATE B
Town and Country Planning (Development Management Procedure) (England) Order 2015 Certificate under Article 14
I certify/ The applicant certifies that I have/the applicant has given the requisite notice to everyone else (as listed below) who, on the day
21 days before the date of this application, was the owner* and/or agricultural tenant** of any part of the land or building to which this
application relates.
* “owner” is a person with a freehold interest or leasehold interest with at least 7 years left to run.
** “agricultural tenant” has the meaning given in section 65(8) of the Town and Country Planning Act 1990
Name of Owner / Agricultural Tenant
Address
Date Notice Served
Signed - Applicant: Or signed - Agent: Date (DD/MM/YYYY):
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15. Ownership Certificates and Agricultural Land Declaration (continued)
CERTIFICATE OF OWNERSHIP - CERTIFICATE C
Town and Country Planning (Development Management Procedure) (England) Order 2015 Certificate under Article 14
I certify/ The applicant certifies that:
Neither Certificate A or B can be issued for this application
All reasonable steps have been taken to find out the names and addresses of the other owners* and/or agricultural tenants** of
the land or building, or of a part of it, but I have/ the applicant has been unable to do so.
* “owner” is a person with a freehold interest or leasehold interest with at least 7 years left to run.
** “agricultural tenant” has the meaning given in section 65(8) of the Town and Country Planning Act 1990
The steps taken were:
Name of Owner / Agricultural Tenant
Address
Date Notice Served
Notice of the application has been published in the following newspaper
(circulating in the area where the land is situated):
On the following date (which must not be earlier
than 21 days before the date of the application):
Or signed - Agent:Signed - Applicant: Date (DD/MM/YYYY):
CERTIFICATE OF OWNERSHIP - CERTIFICATE D
Town and Country Planning (Development Management Procedure) (England) Order 2015 Certificate under Article 14
I certify/ The applicant certifies that:
Certificate A cannot be issued for this application
All reasonable steps have been taken to find out the names and addresses of everyone else who, on the day 21 days before the
date of this application, was the owner* and/or agricultural tenant** of any part of the land to which this application relates, but I
have/ the applicant has been unable to do so.
* “owner” is a person with a freehold interest or leasehold interest with at least 7 years left to run.
** “agricultural tenant” has the meaning given in section 65(8) of the Town and Country Planning Act 1990
Signed - Applicant: Or signed - Agent: Date (DD/MM/YYYY):
The steps taken were:
On the following date (which must not be earlier
than 21 days before the date of the application):
Notice of the application has been published in the following newspaper
(circulating in the area where the land is situated):
16. Planning Application Requirements - Checklist
Please read the following checklist to make sure you have sent all the information in support of your proposal. Failure to submit all
information required will result in your application being deemed invalid. It will not be considered valid until all information required by
the Local Planning Authority has been submitted.
The original and 3 copies of a completed and dated
application form:
The original and 3 copies of the plan which identifies
the land to which the application relates drawn to an
identified scale and showing the direction of North:
The original and 3 copies of other plans and drawings or
information necessary to describe the subject of the application:
The correct fee:
The original and 3 copies of a design and access statement,
if required (see help text and guidance notes for details):
The original and 3 copies of the completed, dated
Ownership Certificate (A, B, C or D – as applicable)
and Article 14 Certificate (Agricultural Holdings):
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17. Declaration
I/we hereby apply for planning permission/consent as described in this form and the accompanying plans/drawings and additional
information. I/we confirm that, to the best of my/our knowledge, any facts stated are true and accurate and any opinions given are the
genuine opinions of the person(s) giving them.
Or signed - Agent:Signed - Applicant: Date (DD/MM/YYYY):
(date cannot be
pre-application)
18. Applicant Contact Details
Telephone numbers
Country code:
National number:
Extension
number:
Country code:
Mobile number (optional):
Country code:
Fax number (optional):
Email address (optional):
19. Agent Contact Details
Telephone numbers
Country code:
National number:
Extension
number:
Country code:
Mobile number (optional):
Country code:
Fax number (optional):
Email address (optional):
20. Site Visit
Can the site be seen from a public road, public footpath, bridleway or other public land?
No
Yes
If the planning authority needs to make an appointment to carry
out a site visit, whom should they contact? (Please select only one)
Other (if different from the
agent/applicant's details)
ApplicantAgent
If Other has been selected, please provide:
Contact name: Telephone number:
Email address:
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