Version 2018.1
Planning application for development relating to the onshore extraction of oil and gas
1. Applicant Name and Address
Title: First name:
Last name:
Company
(optional):
Unit:
House
number:
House
suffix:
House
name:
Address 1:
Address 2:
Address 3:
Town:
County:
Country:
Postcode:
2. Agent Name and Address
Title: First name:
Last name:
Company
(optional):
Unit:
House
number:
House
suffix:
House
name:
Address 1:
Address 2:
Address 3:
Town:
County:
Country:
Postcode:
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Upon receipt of this form and any supporting information, it is the responsibility of the Local Planning Authority to inform you of its
obligations in regards to the processing of your application. Please refer to its website for further information on any legal, regulatory and
commercial requirements relating to information security and data protection of the information you have provided.
Please be aware that once you have downloaded this form, Planning Portal will have no access to the form or the data you enter into it. Any
subsequent use of this form is solely at your discretion, including the choice to complete and submit it to a Local Planning Authority in
agreement with the declaration section.
Publication on Local Planning Authority websites
Information provided on this form and in supporting documents may be published on the authority's planning register and
website.
Please ensure that the information you submit is accurate and correct and does not include personal or sensitive information. If you require
any further clarification, please contact the Local Planning Authority directly.
Find contact details for Local Planning Authorities: https://www.planningportal.co.uk/lpasearch
If printed, please complete using block capitals and black ink.
Town and Country Planning Act 1990
Environment Act 1995
Privacy Notice
This form is provided by Planning Portal and based on the requirements provided by Government for the sole purpose of submitting
information to a Local Planning Authority in accordance with the legislation detailed on this form and 'The Town and Country Planning
(Development Management Procedure) (England) Order 2015 (as amended)'.
Version 2018.1
5. Type of Application
Is the application for:
a) Full planning permission for oil and gas working including exploratory,
appraisal and production phases;
Yes
No
b) Full planning permission for new development involving the storage, treatment
or disposal of controlled waste including ancillary and associated development?
Yes
No
c) Renewal of unimplemented permission?
Yes
No
If yes, give date and reference number of unimplemented permission:
d) Renewal of temporary permission?
Yes
No
If yes, give date and reference number of temporary permission:
e) Extension to an existing site including associated development?
Yes
No
If yes, give date and reference number of existing permission:
f) Variation of condition(s)?
Yes
No
If yes, give date and reference number of existing permission and the condition(s) sought to be amended:
3. Site Address Details
Postcode
(optional):
Easting:
Northing:
Description of location or a grid reference.
(must be completed if postcode is not known):
Description:
Please provide the full postal address of the application site, or
otherwise a full grid reference or site description.
4. Pre-application Advice
Has assistance or prior advice been sought from the local
authority about this application?
NoYes
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?
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5. Type of Application (continued)
g) Review of conditions applying to Mineral Permissions (ROMPs)?
Yes
No
If yes, give date and reference number of permission:
h) Other (please give details):
Are you or anyone else with an interest in the land willing to consolidate or update
existing permissions including associated development on the site?
Yes
No
Please give details:
Previous permissions for minerals development on the site (if any):
Ref No: Date of Decision:
Ref No:
Date of Decision:
Ref No: Date of Decision:
Ref No: Date of Decision:
6. Type of Development
Brief description of the development including main oils and gases to which the application relates and the plant and machinery to be
used:
Quantity (cubic metres): Period of permission sought, if known (in years):
What phase of onshore oil and gas development does this application cover:
Production phase
Appraisal phase
Exploratory phase
Which hydrocarbon licence block is this development located in?
Is an Environmental Statement attached to this application?
Yes No
Please state the surface site area in hectares (ha):
Version 2018.1
7. Plans, Drawings and Other Supporting Material
Document(s):Address:
Please provide the address where information can be inspected:
Reference Number:
Title:
Title:
Reference Number:
Reference Number:
Title:
Title:
Reference Number:
List here the plans and drawings submitted with the application. See guidance notes for the drawings which are required or would be
advisable.
Please provide details of equipment to be used as part of the application including, where possible the maximum height and type of
drilling rig to be used.
8. Equipment and Method used
9. Hours of Operation
Please state hours of operation:
Use Monday to Friday Saturday
Sunday and
Bank Holidays
Not known
Any additional information (such as hours of use of other machinery within the site-generators, pumps, etc.)
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10. Pedestrian and Vehicle Access, Roads and Rights of Way
Is a new or altered vehicle access proposed to or from the public highway?
Yes No
Is a new or altered pedestrian access proposed to or from the public highway?
Yes No
Are there any new public roads to be provided within the site?
Yes
No
Are there any new public rights of way to be provided within or adjacent to the site?
Yes No
Do the proposals require any diversions /extinguishments and/or creation of rights of way whilst the site
is being worked?
Yes
No
If you answered Yes to any of the above questions, please show details on your plans/drawings and state the reference of the plan(s)/
drawings(s):
No
Yes
Are there any new public rights of way to be provided with or adjacent to the site after extraction?
Please complete the following information regarding employees:
Full-time Part-time
Total full-time
equivalent
Existing employees
Proposed employees
11. Employment
Please describe the current use of the site:
12. Existing Use
13. Trees and Hedges
Are there trees or hedges on the proposed development site?
And/or: Are there trees or hedges on land adjacent to the proposed development site that
could influence the development or might be important as part of the local
landscape character?
If Yes to either or both of the above, you may need to provide a full Tree Survey, at the discretion of your local planning authority. If a
Tree Survey is required, this and the accompanying plan should be submitted alongside your application. Your local planning authority
should make clear on its website what the survey should contain, in accordance with the current 'BS5837: Trees in relation to design,
demolition and construction - Recommendations'.
NoYes
Yes No
14. Biodiversity, Geological and Archaeological Conservation
To assist in answering the following questions refer to the guidance notes for further information on when there is a reasonable likelihood
that any important biodiversity, geological or archaeological features may be present or nearby and whether they are likely to be
affected by your proposals.
Having referred to the guidance notes, is there a reasonable likelihood of the following being affected adversely or conserved and
enhanced within the application site, or on land adjacent to or near the application site?
a) Protected and priority species:
Yes, on land adjacent to or near the proposed development
No
Yes, on the development site
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14. Biodiversity, Geological and Archaeological Conservation continued.
No
Yes, on land adjacent to or near the proposed development
Yes, on the development site
b) Designated sites, important habitats or other biodiversity
features:
c) Features of geological or archaeological conservation importance:
Yes, on the development site
Yes, on land adjacent to or near the proposed development
No
15. Designated Areas
Is the site wholly or partly within any of the following designations? Please tick all that apply:
Conservation AreaWorld Heritage Site
National Park (including The Broads and The New Forest)
Special Area of Conservation
Special Protection Area/Ramsar site Area of Outstanding Natural Beauty
Green Belt
Site of Special Scientific Interest
National Nature Reserve None of the above
17. Foul Sewage
Does your proposed development produce any foul sewage?
Yes No
Please state how foul sewage is to be disposed of:
Mains sewer
Cess pit
Septic tank
Package treatment plant Other
Are you proposing to connect to the existing drainage system?
Yes No Not yet established
If Yes, please include the details of the existing system on the application drawings and state references for the plan(s)/drawing(s). If no,
please provide a drawing showing what, if any, alternative foul sewage disposal system you propose:
16. Assessment of Flood Risk
Is the site within an area at risk of flooding?
No
Yes
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?
No
Yes
Main sewer
Pond/lakeSoakaway
Existing watercourse
Sustainable drainage system
Interceptor ditch and sumps
How will surface water be disposed of?
Version 2018.1
Please provide further details:
19. Hazardous Substances
Does the proposal involve the use or storage of any substances requiring hazardous substances consent?
Yes
No
State details and proposed facilities for the storage of oil, fuel and chemicals and the proposed means of their protection (not covered by
question 19 above).
20. Storage
18. Trade Effluent
Does the proposal involve the need to
dispose of trade effluents or waste?
If Yes, please describe the nature, volume and means of disposal of trade effluents or waste:
No
Yes
What is the applicant's interest in the site?
Surface land owner(s):
21. Site Ownership
Name Address
Version 2018.1
No
Yes
If Yes, summarise the purpose of the agreement below:
Is any outline or draft agreement included with this application?
22. Voluntary Agreements / Planning Obligations
What is the applicant's interest in the adjoining land, if any? Please outline any additional land owned by the applicant, and the area
where drilling is likely to take place.
21. Site Ownership continued
Version 2018.1
23. Ownership Certificate and Agricultural Land Declaration
Name of Owner / Agricultural Tenant
Address
Date Notice Served
Parish/Ward
Location of notice
Date posted
Parish/Ward
Location of notice
Date posted
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):
I/the applicant took the following steps to protect and replace the notice:
There is no person (other than me/the applicant) who, on the 21 days before the date of the accompanying application, was the
owner(a) of any part of the land to which this application relates on which surface works are required for the development,
whom I/the applicant know/s to be such a person and whose name and address is know to me/the applicant but to whom I/the
applicant have/has have not given the requisite notice.
I have/the applicant has posted the requisite notice, sited and displayed in such a way as to be easily visible and legible by
members of the public, in at least one place in every parish or ward within which there is situated any part of the land to which
the application relates, as listed below.
Save as specified below this/these notice/s were left in position for not less than seven days in the period of 21 days immediately
preceding the making of the application.
The following notice/s was/were, however, left in a position for less than seven days in the period of more than 21 days
immediately preceding the making of the application.
This happened because it/they was/were removed/obscured/defaced before seven days had passed during the period of 21 days
mentioned above. This was not my/the applicant's fault or intent.
CERTIFICATE OF OWNERSHIP
Town and Country Planning (Development Management Procedure) (England) Order 2015 Certificate under Article 14
I certify that:
I have/the applicant has given the requisite notice to the persons listed below being persons who, on the day 21 days before the
date of this application, were owners of any part of the land to which the application relates on which surface works are required
for the development.
* “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
Version 2018.1
25. 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.
(date cannot be
pre-application)
Date (DD/MM/YYYY):Or signed - Agent:Signed - Applicant:
The correct fee:
The original and 3 copies of the completed, dated
Ownership Certificate and Agricultural land
declaration:
The original and 3 copies of other plans and drawings or
information necessary to describe the subject of the application:
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 a completed and dated
application form:
24. 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.
26. Applicant Contact Details
Telephone numbers
Country code:
National number:
Extension
number:
Country code:
Mobile number (optional):
Country code:
Fax number (optional):
Email address (optional):
27. Agent Contact Details
Telephone numbers
Country code: National number:
Extension
number:
Country code:
Mobile number (optional):
Country code:
Fax number (optional):
Email address (optional):
29. 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:
If Yes, please provide details of their name, role and how you are related to them.
NoYes
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 the following statements apply to you and/or agent?
28. Authority Employee / Member
It is an important principle of decisions-making that the process is open and transparent. For the purposes of this question, "related to"
means related, by birth or otherwise, closely enough that a fair-minded and informed observer, having considered the facts, would
conclude that there was bias on the part of the decision-maker in the local planning authority.
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