Version ECAB 2019
Application to determine if prior approval is required for a proposed:
Change of Use from Shops (Class A1), Financial and Professional Services (Class A2), Takeaways (Class A5),
Betting Offices, Pay Day Loan Shops or Launderettes (Sui Generis Uses); or a Mixed Use combining use as a
Dwellinghouse (Class C3) with a Shop (Class A1) or Financial and Professional Service (Class A2),
Betting Office, Pay Day Loan Shop or Launderette (Sui Generis Uses); to Dwellinghouses (Class C3), and for
building operations reasonably necessary for the conversion
1. Applicant Name and Address
Title: First name:
Last name:
Address 1:
Address 2:
Address 3:
Town:
County:
Country:
Postcode:
Building
name:
Unit:
Company
(optional):
Suffix:Number:
2. Agent Name and Address
Title: First name:
Last name:
Building
name:
Unit:
Address 1:
Address 2:
Address 3:
Town:
County:
Country:
Postcode:
Suffix:Number:
Company
(optional):
Town and Country Planning (General Permitted Development) (England) Order 2015 (as amended) - Schedule 2, Part 3, Class M
This form is specifically designed to be printed and completed offline.
Please complete this form in block capitals using black ink to facilitate scanning.
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.
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.
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.
Local Planning Authority details:
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You are advised to read the accompanying guidance notes and per-question help text.
If you would rather make this application online, you can do so on our website:
https://www.planningportal.co.uk/apply
Version ECAB 2019
Unit: Number: Suffix:
Building name:
Address 1:
Address 2:
Address 3:
Address 4:
Postcode:
Please provide the full postal address of the application site.
3. Site Address Details
Was the use of the building on 20th March 2013 (or the last use before that date) one of the following:
- a use within Class A1 (Shops) or Class A2 (Financial and Professional services);
- a use as a betting office, pay day loan shop or launderette; or
- a mixed use combining use as a dwellinghouse with one of the above uses;
- a use within Class A5 (Hot Food Takeaways).
NoYes
Is the building:
- in a conservation area;
- in an area of outstanding natural beauty;
- in an area specified by the Secretary of State for the purposes of enhancement and protection of the natural beauty and amenity of the
countryside;
- in the Broads;
- in a National Park;
- in a World Heritage Site;
- in a site of special scientific interest;
- in a safety hazard area;
- in a military explosives storage area;
- a listed building; or
- a scheduled monument.
If you have answered no above, the proposal will exceed the limits set by legislation. In this circumstance, you should not continue with
this application and seek advice from the Local Planning Authority on the best course of action.
NoYes
If you have answered yes above, the proposal will exceed the limits set by legislation. In this circumstance, you should not continue with
this application and seek advice from the Local Planning Authority on the best course of action.
4. Eligibility
If you have answered yes above, the proposal will exceed the limits set by legislation. In this circumstance, you should not continue with
this application and seek advice from the Local Planning Authority on the best course of action.
No / Not ApplicableYes
Was the building's use within Class A1 (Shops) or Class A2 (Financial and Professional services) only granted by a change of use under
permitted development rights?
Will the total combined floor space in the building (previously and in this proposal) changed to Class C3 (Dwellinghouses) exceed
150 square metres?
If you have answered yes above, the proposal will exceed the limits set by legislation. In this circumstance, you should not continue with
this application and seek advice from the Local Planning Authority on the best course of action.
NoYes
If you have answered yes above, the proposal will exceed the limits set by legislation. In this circumstance, you should not continue with
this application and seek advice from the Local Planning Authority on the best course of action.
NoYes
Will the external dimensions of the resulting building extend beyond the existing building at any point?
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Version ECAB 2019
5. Description of Proposed Works, Impacts and Risks
Are any associated building works or other operations required to make this change?
Note that such works are restricted to those reasonably necessary to convert the building for use as a dwellinghouse
(including partial demolition).
NoYes
If yes, please provide details of the design and external appearance of the building in regard to these building works or other operations
(including partial demolition):
Please describe the proposed development:
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Version ECAB 2019
5. Description of Proposed Works, Impacts and Risks (continued)
Please provide details of any transport and highways impacts and how these will be mitigated:
Note that this figure should be the number of dwellinghouses proposed by the development that is additional to the number of
dwellinghouses on the site immediately prior to the development.
What will be the net increase in dwellinghouses:
Please provide details of any contamination risks and how these will be mitigated:
Please provide details of any flooding risks and how these will be mitigated.
A flood risk assessment should accompany the application where the site:
- is in Flood Zones 2 or 3 (Check online: https://flood-map-for-planning.service.gov.uk/ ); or
- is in an area with critical drainage problems (Check with the Local Planning Authority, it will have been notified of such areas by the
Environment Agency).
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Version ECAB 2019
5. Description of Proposed Works, Impacts and Risks (continued)
Where the building is located in a key shopping area, please provide details of any undesirable impact on the sustainability of that
shopping area:
Please provide details of the impact on the adequate provision of services, based on the loss of the building's current use.
For example:
- Would there be a reasonable prospect of the building being used under it's current use class going forward?
- Would a unique shop, service or food provision be lost from the area if the use is changed?
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Version ECAB 2019
6. Checklist
Please read the following checklist to make sure you provide all the required information in support of your proposal.
The information provided should include all the details necessary for the Local Planning Authority to determine if the proposal complies
with permitted development legislation, and if its prior approval will be required.
If sufficient information is not provided the Local Authority can either request it, or refuse the application.
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 the
Planning Portal's accredited suppliers:
https://www.planningportal.co.uk/buyaplanningmap
All sections of this application completed in full, dated
and signed.
The correct fee
7. Declaration
(date cannot be
pre-application)
Signed - Applicant: Or signed - Agent: Date (DD/MM/YYYY):
I/we hereby apply for a determination as to whether prior approval will be required 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.
Country code:
National number: Extension:
Country code:
Mobile number (optional):
Country code:
Fax number (optional):
Email address:
Country code:
National number:
Extension:
Country code:
Mobile number (optional):
Country code:
Fax number (optional):
Email address:
Telephone numbers
9. Agent Contact Details
Telephone numbers
8. Applicant Contact Details
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