Application for Express Consent

Please complete in BLOCK CAPITALS and in black ink.

The person here below named as the applicant is responsible for payment of the appropriate fee.

All relevant questions on this form must be answered.

Guidance notes are available on request.

1. a) Full name of applicant

| FIRST NAMES MANAGEMENT LIMITED | | | --- | --- | | Please include all first names and surname or full details where an applicant is 'trading as' or a limited company. | |

b) Address of applicant

| CLERICAL MEDICAL HOUSE, VICTORIA ROAD, DOUGLAS | | | --- | --- | | Postcode IM2 4DF | |

| Telephone number | | | --- | --- | | Home | | | [email protected] | |

1. a) Full name of Agent

| ELLIS BROWN ARCHITECTS | | | --- | --- | | |

| b) Address of Agent | | | --- | --- | | 12 STRATHALLAN CRESCENT, QUEENS PROMENADE, DOUGLAS | | | Postcode IM2 4NR | |

| Telephone number | | | --- | --- | | 621375 | |

| Agent E-Mail Address | | | --- | --- | | [email protected] | |

c) If using an Agent, please indicate if the Agent is to be issued with the acknowledgement letter and undertake the responsibility for affixing the site at the development site.

Please Note: If this box is not completed all correspondence will be directed to the Agent.

1. Site of hoarding or advertisement.

| CLERICAL MEDICAL HOUSE | | | --- | --- | | VICTORIA ROAD, DOUGLAS | |

1. Applicant's interest in the site. (e.g. owner, tenant, potential purchaser)

| OWNER | | | --- | --- | | Please ensure that the following information (question 5) corresponds with the details included in the accompanying and compulsory certificate of ownership (certificate 02). | |

1. Name and Address of:

a) The site owner, if different from the applicant. Please state all names, including first names in full

b) The name of occupier or tenant of the site if different from above.

| CLERICAL MEDICAL HOUSE | | | --- | --- | | VICTORIA ROAD, DOUGLAS | |

Putting the Customer First ADV1(7)(i)

6. Local Authority District.

7. Description of the proposed development. INCLUDE content (text and graphics), size, construction and whether illuminated. If so, ALL details must be provided

PROPOSED ERECTION OF FIVE SIGNS, TWO ILLUMINATED AND THREE UN-ILLUMINATED, AS INDICATED AND DETAILED ON THE ENCLOSED PLANS.

| RECEIVED | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |