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Isle of Man Government, Department of Environment, Food & Agriculture Bucks Road, Douglas, IM1 3PN T: 01624 685950 E: [email protected] Ref: DSFX1612962438649 1 / 5 The Town and Country Planning Act 1999 The Town and Country Planning (Certificates of Lawful Use or Development) Regulations 2005 as amended Application for a Certificate of Lawful Use or Development Site Address A plan must accompany this application to identify the land. The land should be outlined in red. Street Address * Coolibane House Main Road Town/City * Sulby Postcode * IM7 2HR Applicant Address Is the applicant's address the same as the site address? * Yes

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Ref: DSFX1612962438649 2 / 5 Applicant Details Please provide the Applicant's Name and/or the applying Company Name. Name Title First name(s) Surname Company name Street address * Cooilbane House Main Road Town/City* Sulby Postcode* IM7 2HR Telephone number * Mobile number Email * Applicants Interest Is the applicant the owner of the site? * Yes Agent Details Are you an agent acting on behalf of the applicant?* Yes Redacted Redacted Redacted Redacted Redacted

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Ref: DSFX1612962438649 3 / 5 Agent Details Please provide the Agent's name and/or Agency name. Name Title Mr First name(s) Gordon Surname Clarke Agency name GCA Ltd Street address * The Design Studio Carmodil Beg Glen Road Town/City* Ballaugh Postcode* IM75JD Telephone number * 01624898402 Mobile number Email * [email protected] Details of Section 24(1) of the 1999 Act Under which of the following paragraphs of Section 24(1) of the 1999 Act is this application made? * To make lawful operations which have been carried out in, on, over or under the land. Details of Section 24(1) of the 1999 Act Please state what the operation(s) were/are.* External Disability Lift Enclosure & Lobby Please state the date the operations started, or, in the case of operations carried out without planning approval, the date on which they were substantially completed.* 31/10/2014

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Ref: DSFX1612962438649 4 / 5 Details of Section 24(1) of the 1999 Act Please provide your reasons, if any, for considering the use, operations or other matter described in this application as lawful and state such other information that you consider relevant to this application.* Enclosure built to provide disability lift and access. The internal circulation areas less the lift cab access being 12m2. Pre-consultation advice obtained at the time was that this would be permitted without Planning. However the lift enclosure must be set back from the main elevation and carried out sympathetically and subservient to the main 3 storey house. The lift being completed and operated from late 2014. Declaration The Department of Environment, Food & Agriculture is a data controller for the purposes of the General Data Protection Legislation and requires the information on this form to comply with its legal obligations under the Town and Country Planning Act 1999 and subordinate The Town and Country Planning (Certificates of Lawful Use or Development) Regulations 2005 as amended. Your personal information will be held by the DEFA for the purposes of processing this application and may be used to ensure compliance with the provisions of the Town & Country Planning Act and in particular Part 4 Enforcement of Control. Some of the information you provide, such as your name, address and contact detail will be shared at our public counter, with the Local Authority and as part of the application image via our online service, in order to give notice and publicise receipt of the application. It may also be shared within the DEFA or other Government Departments, boards or offices for the purposes of statutory functions. We will only keep these details for as long as we require them, and in accordance with the General Data Protection Legislation. You may withdraw your details at any time if you no longer wish us to process your application. Full details of how and why the DEFA processes your personal information are contained in our P&BC Privacy Notice on our website here. The Data Protection Officer can be contacted on 686781 or by email at DPO- [email protected] Statement The Department may by notice in writing require the applicant to provide such further information as may be specified to assist in its consideration of the application. On validation of the application, the Department will give Notice of the application to the Local Authority. The Notice will invite written representation as to the content of the application. Under Section 24(4) of the Town and Country Planning Act 1999, any person who for the purpose of procuring a particular decision on an application for a certificate: a) knowingly or recklessly makes a statement which is false or misleading in a material particular; b) with intent to deceive, use a document which is false or misleading in a material particular; c) with intent to deceive, withholds any material information; is guilty of an offence and may be liable: On summary conviction to custody for a term not exceeding 6 months or to a fine not exceeding £10000, or both; On convictions on information to custody for a term not exceeding 2 years, or to a fine, or both. Please note that the Department retains powers under Section 24(5) of the 1999 Act, Section 5 of the Regulations, to revoke a certificate. ✓ I/We hereby apply for a certificate of lawfulness, in respect of the matters set out above and in accordance with the information submitted herewith. To the best of my knowledge and belief, all the information given in this application is true, and the documents provided herewith are accurate. Full Name * Gordon Clarke Capacity If signing on behalf of a company, please clearly state your relationship. Director Date * 10/02/2021

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Ref: DSFX1612962438649 5 / 5 Fee On submission of this form we shall validate your application and send a confirmation email to you (the applicant). This email will contain a link to our payment site for any payment(s) required to support your application. Failure to pay the correct amount (if applicable) will result in a delay, refer to the relevant fee table(s) for clarification. Where fee(s) are exempt please enter £0. See Relevant 'Fees Order' on our website here. Confirm the Application for Certificate of Lawfulness or Development fee payable. 0 Email confirmation On submission an email confirmation will be sent using the details below Forename Gordon Surname /Company Name * Clarke Email* [email protected] Telephone 01624898402