$Date:: 2010-03-17 #$ $Revision: 2341 $
If Yes, which of the following does the proposal involve?
Does the proposal include the partial or
total demolition of a listed building?
a) Total demolition of the listed building:
b) Demolition of a building within
the curtilage of the listed building:
c) Demolition of a part of the listed building:
Please provide a brief description of the building or part of the
building you are proposing to demolish:
If the answer to c) is Yes:
i) What is the total volume of the
listed building?(cubic metres)
ii) What is the volume of the part
to be demolished?(cubic metres)
iii) What was the (approximate) date of the
erection of the part to be removed? (MM/YYYY)
(date must be pre-application submission)
Why is it necessary to demolish or extend (as applicable) all or part
of the building(s) and or structure(s)?
10. Listed Building Alterations
If Yes, do the proposed works include:
(you must answer each of the questions)
Do the proposed works include alterations
to a listed building?
a) Works to the interior of the building?
b) Works to the exterior of the building?
c) Works to any structure or object fixed
to the property (or buildings within
its curtilage) internally or externally?
d) Stripping out of any internal wall, ceiling
or floor finishes (e.g. plaster, floorboards)?
If the answer to any of these questions is Yes, please provide
plans, drawings, photographs sufficient to identify the location,
extent and character of the items to be removed, and the
proposal for their replacement, including any new means of
structural support and state references for the plan(s)/drawing(s):
11. Listed Building Grading
Please state the grading (if known) of the building in the list of
Buildings of Special Architectural or Historic interest? (Note: only
one box must be ticked)
Ecclesiastical Grade I
Ecclesiastical Grade II
Ecclesiastical Grade II*
12. Immunity From Listing
Has a Certificate of Immunity from Listing been sought in respect of
Yes No Don't know
If Yes, please provide the result of the application:
Will the proposed works affect
existing car parking arrangements?
If Yes, please describe:
14. 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
If Yes, please provide details of the name, relationship and role
Do any of these
statements apply to you?