Notification of a Proposed Change of Use to Dwelling(s)
1. Developer Name and Address 2. Agent Name and Address
Title: First name:
Last name:
Address 1:
Address 2:
Address 3:
Town:
County:
Country:
Postcode:
Title: First name:
Last name:
House
name:
Unit:
Company
(optional):
House
name:
Unit:
Company
(optional):
Address 1:
Address 2:
Address 3:
Town:
County:
Country:
Postcode:
You can use the Planning Portal to find the correct email address for your local planning authority.
www.planningportal.gov.uk/localauthoritysearch
Town and Country Planning (General Permitted Development) Order 1995 (as amended)
Development consisting of a change of use of a building and any land within its curtilage to a use
falling within Class C3 (dwellinghouses) of the Schedule to the Use Classes Order from a use falling
within Class B1(a) (offices) of that Schedule*
House
suffix:
Publication of notifications on planning authority websites
Please note that the information provided on this notification 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 note: you need to download the form to complete it electronically. Please complete using block capitals and black ink if sending by
post.
Unit: Building number:
Building name:
Address 1:
Address 2:
Address 3:
Postcode:
Address 4:
Building suffix:
Please provide the full postal address of the application site.
3. Site Address Details
House
suffix:
House
number:
House
number:
*Development is not permitted where the building is on Article 1(6a) land, is a Listed Building or Scheduled Ancient Monument, or is or
forms part of a safety hazard area or military explosives storage area.
Planning Portal
www.planningportal.gov.uk/localauthoritysearch
Please describe the proposed development, including relevant information covering transport and highways impacts of the
development; contamination risks on the site; and flooding risks on the site.
4. Description of the Proposed Development
A plan indicating the site and showing the proposed development. A
plan drawn to an identified scale will assist the authority in assessing your
development proposal. Plans can be bought from one of our accredited
suppliers using our Buy-a-Plan service
All sections of this notification completed in full, dated
and signed (typed signature if sent electronically).
5. 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 could result in your notification being deemed invalid. It will not be considered valid until all information required by
the Local Planning Authority has been submitted. Please note that as part of this procedure, if any objections are received the Local
Planning Authority may require submission of further information at a later date.
(www.planningportal.gov.uk/buyaplan)
What was the use of the building immediately before 30th May 2013 or the last use before that date?
If the building was not in use immediately before 30th May 2013, when was it last in use?
Date (DD/MM/YYYY)
Buy-a-Plan service
6. Declaration
I/we hereby apply for prior approval as described in this notification 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)
Signed - Developer: Or signed - Agent: Date (DD/MM/YYYY):
Country code:
National number:
Extension
number:
Country code:
Mobile number (optional):
Country code:
Fax number (optional):
Email address:
Country code:
National number:
Extension
number:
Country code:
Mobile number (optional):
Country code:
Fax number (optional):
Email address:
Telephone numbers
8. Agent Contact Details
Telephone numbers
7. Developer Contact Details
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