High Streets Heritage Action Zones:
Expression of Interest
Application Form
High Streets Heritage Action Zones: Expression of Interest
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Please refer to the accompanying High Streets Heritage Action Zone
(HSHAZ) Guidance Notes while reading this HSHAZ Expression of
Interest Application form.
This Expression of Interest is the only opportunity to apply and will
be competitive.
The closing date for submission of your application is 12:00 noon on
12 July 2019.
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Part
1: General Details
Q1.1 Lead Applicant details
a. Name of Lead Applicant Organisation:
b. Name of Lead Applicant contact:
c. Job title of Lead Applicant contact:
d. Business address of Lead Applicant contact:
e. Daytime telephone number for Lead Applicant contact:
f. E-mail address for Lead Applicant contact:
Q1.2 Scheme details
a. Location of your proposed High Streets HAZ:
b. Conservation Area and wards covered by your
proposed High Streets HAZ:
c. Name of Regional Historic England Office to
which your proposed High Streets HAZ relates
(see Guidance Notes for full list):
d. Name of Local Authority Area within which your
proposed High Streets HAZ is located:
e. Name of your scheme:
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Part 2: Essential Criteria
Please refer to the accompanying High Streets Heritage Action Zone (HSHAZ)
Guidance Notes while you are completing your Expression of Interest (EoI).
Essential Criteria Question
Applicant
to Confirm
2.1 High Streets HAZs must be in a
Conservation Area.
Have you included evidence to show
that your proposed High Streets HAZ is
in a Conservation Area?
Yes No
2.2 High Streets HAZs must be delivered
through a partnership, and include
the local authority as a partner (the
local authority does not need to be
the lead partner, but there needs to
be evidence of their commitment
to the initiative).
Have you included evidence of
commitment from partners to your
proposed High Streets HAZ (e.g.
signed letters of support from senior
representatives)?
Yes No
2.3 High Streets HAZs must be delivered
with demonstrable support of the
local community.
Have you included evidence of
support from the local community for
your proposed High Streets HAZ (e.g.
assessment of community support,
letters of support from community
bodies)?
Yes No
2.4 High Streets HAZs must be capable
of delivery (scheme completion) in
four years (April 2020-March 2024).
Have you included evidence that
your proposed High Streets HAZ is
deliverable within a four-year period
(e.g. a high-level programme)?
Yes No
If the above are met then the application will move to the next stage of assessment below.
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Part
3: Supporting Information
A. The Place
Q3.1 Please briefly describe your proposed High Streets HAZ area as it is
(750 words maximum, include maps and supporting evidence as annex
documents if required).
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Please also provide the following specific data:
Index of Multiple Deprivation IMD Ranking
Community Wellbeing Index Wellbeing Score
Vacancy rates within the high
street
% units vacant
Designated heritage assets
within proposed High Street
HAZ area
No. of assets
Q3.2 Please briefly describe, with evidence, the untapped potential of the
high street/ town centre (750 words maximum).
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B. Your Proposed High Streets HAZ
Q3.3 Please briefly outline your proposed High Streets HAZ, the scheme
and high-level vision for the high street / town centre. This will need
to refer to the challenges and potential referenced in 3.1 and 3.2
(750 words maximum).
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Q3.4 Please briefly outline the anticipated impact of delivering your
proposed scheme and how these ou
tcomes will develop into a
s
ustainable legacy (750 words maximum).
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Q3.5 Please briefly outline how you will secure the legacy of this scheme
after the funding has ended (750 words maximum).
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C. Partnerships
Q3.6 Provide a comprehensive list of scheme partners, including evidence of
their support (e.g. letters of support from senior representatives)
(350 words maximum and supporting information in an appendix).
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Q3.7 Provide details of how the partnership will be led and managed during
the course of the delivery period (e.g. governance / organogram or
other illustrations) (750 words maximum).
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Q3.8 Please confirm whether you anticipate appointing an FTE Project
O
fficer post or describe your existing resources in place to
manage delivery of the scheme (350 words maximum).
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D. Deliverability
Q3.9 Describe the deliverability of your scheme here (750 words maximum).
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Q3.10 Is there interest and support from existing building owners and
stakeholders in the HSHAZ bid? (350 words maximum.)
Q3.11 Are there development plan policies or other regeneration initiatives
that support your proposed scheme and/or are there any development
threats that could undermine the outcomes? (350 words maximum.)
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Q3.12 What is your broad estimate of the total cost of the eligible work
required for your scheme (broken down by year in which that cost
will fall)?
Estimated
Costs
Year 1 Year 2 Year 3 Year 4 Total
Sum £ £ £ £ £
Q3.13 How much funding in total are you asking us for (broken down by year)?
Request from
HS HAZ Fund
Year 1 Year 2 Year 3 Year 4 Total
Sum £ £ £ £ £
Q3.14 How much funding (from you, partners and/or other sources) can you
support the scheme with?
Please detail
financial
commitment
from applicant/
other sources
Year 1 Year 2 Year 3 Year 4 Total
£ £ £ £ £
£ £ £ £ £
£ £ £ £ £
£ £ £ £ £
£ £ £ £ £
£ £ £ £ £
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Q3.15 Provide details of the anticipated non-financial resource
commitments that will be made by partners and/or other sources.
Please detail
non-financial
commitment
from applicant/
other sources
Year 1 Year 2 Year 3 Year 4 Total
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E. Communities and Engagement
Q3.16 Describe how you will engage with communities to design and deliver
your scheme (750 words maximum).
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F. Cultural Programme
Q
3.17 Outline below your capacity to support the Cultural Programme
(750 words maximum).
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G. Declaration Form
Your completed EoI must be signed by the Lead Applicant contact named in Q1.2b.
I confirm the applicant organisation has read and accepted the Expression of Interest Guidance Notes
and that the information in this declaration form, together with the supporting information enclosed
with it, is accurate and complete to the best of their knowledge.
Name of Lead Applicant
(in capital letters)
Signature
On behalf of (organisation)
Position in Local Authority or Trust
Date
Please tick to confirm you have attached the following appendices:
Map of the HSHAZ Area
Risk Assessment of the scheme
Please list other annexes below:
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