Fillable form either electronically or in block capitals using (Wycombe District Council)

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Application to modify or discharge a
Section 106 Planning Obligation
Please read the accompanying notes to help you complete this form. Complete the
form either electronically or in block capitals using black ink.
For Office Use Only: App. No:
You should use this form when applying for the modification or discharge of a planning
obligation. For further information refer to The Town and Country Planning (Modification
and Discharge of Planning Obligations) Regulations 1992.
1. Type of Application
• Are you applying to modify a planning obligation? Yes No
• Are you applying to discharge a planning obligation? Yes No
2. Name and Address of Applicant
Name:
Address:
Postcode:
Email address:
Daytime telephone number:
3. Name and Address of Agent
(If completed by Agent)
Name:
Address:
Postcode:
Email address:
Contact name:
Daytime telephone number:
4. Site Address
Please provide the full postal address of the site to which the obligation relates
5. Nature of Applicant’s Interest
Please describe the nature of the Applicant’s interest in this land
6. Details of Planning Obligation to be modified or discharged
Please provide sufficient information to enable us to identify the planning obligation
(planning reference numbers, etc)
7. Reasons for modification or discharge of the Planning Obligation
Please provide the reason(s) you have for applying for the modification or discharge
of the obligation
8. Confirmation
Please confirm your application by signing and dating below
Please note that this form and any supporting information (including any personal details eg. Phone
number, email address, etc) will be seen by Councillors, the applicant, members of the public, and will
be published in full on the Council’s website. For more information please see the privacy policy and
data protection webpages.
Signature:
Date:
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form either electronically or in block capitals using (Wycombe District Council)

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Completed 30 July 2020

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