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20. Please provide details of any supporting information or other details that you would like the Planning Officer to take into account. Please note that you may use a separate sheet to complete this section.

21. 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 1991 and subordinate Town and Country Planning (Development Procedure) Order 2013.
Your personal information will be held by 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 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 DEFA PB&C processes your personal information are contained in our PB&C Privacy Notice available on our website.
The Data Protection Officer can be contacted on 686781 or by email at [email protected].
22. Statement - I hereby enclose four copies of the following:
A copy of this application will be forwarded to the Local Authority in which the site is situated and, where not an application relating to windows, the Network Planning Officer, DOI Highway Services.
PLEASE ALSO ENCLOSE one copy of
To the best of my knowledge and belief, all the information given in this application is true, and the documents provided herewith are accurate.
Signature of Applicant or Agent
Dated 06/06/19
If signing on behalf of a company, please clearly state your relationship.
Should this application be unsupported by adequate and clear site maps and plans outlining all the works proposed, the Department retains the right to reject acceptance and return the application.
Note: no works may be commenced until such time as:
a) on your receipt of the planning Decision Notice the time period for requesting an appeal has expired and no such appeal has been requested, or
b) any Appeal has been completed.
Planning and Building Control Directorate Department of Environment, Food and Agriculture Murray House, Mount Havelock, Douglas, Isle of Man, IM1 2SF Tel: +44 1624 685950 Fax: +44 1624 686443 Email: [email protected]

The Town and Country Planning Act 1999 The Town and Country Planning (Development Procedure) (No2) Order 2013
Application for Planning Approval
1900708
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.
For office use only
Date: 06/06/19
Receipt number: 919430
All relevant questions on this form must be answered.
Guidance notes are available on request.
| 8104300000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
| 5. a) Full name of Agent | | | --- | --- | | b) Address of Agent | Postcode | | Telephone number | | | Agent's e-mail address | |
Please note correspondence is preferred and may be more expeditious via email
c) If you are using an Agent, please specify whether the acknowledgement letter and Site Notice should be sent to the Agent or Applicant, who will be responsible for affixing the Site Notice at the site. Please Note: If this box is not completed all correspondence will be directed to the Agent.
| | | | --- | --- | | 7. Relevant Fee Enclosed (where required) Please note the application will remain invalid until the application fee is paid in full. | £ 165.00 | | Cheques should be made payable to ION Government. | |
If the proposed development would create additional industrial, residential, retail or office floor space, please specify the floor area in square metres This area should be used to where the fee calculus requires it.
Where the application is exempt from a fee under the current fees order, please state the registered charity number.
| | | | --- | --- | | 9. a) Please state the existing use of the site (e.g. residential, office, retail etc.) | | | b) Please state the proposed use of the site. | | | 10. a) Development within a Conservation Area. If yes, please include details of any demolition involved on a separate sheet. | Yes ☐ No ☐ | | b) Works proposed to a Registered Building. If yes, please quote the RB number and complete an application for Registered Building Consent to accompany this form (form RBAP). | Yes ☐ No ☐ | | 11. Would the proposed development involve the creation of, or alteration to, a vehicular or pedestrian access to any public highway (this includes footpaths)? If yes, please provide details. | Yes ☐ No ☐ | | Have you consulted with Highway Services? | Yes ☐ No ☐ | | Please confirm the number of parking spaces within the site. | |
| | | | --- | --- | | 12. Does your proposal involve a change in site levels? If yes, please provide drawings showing the change in site levels (e.g. spot levels or site sections). Please also include a method statement detailing the proposed means of importing fill and/or the means of exporting the fill, including details of the expected quantities involved. | Yes ☐ No ☐ | | 13. Please specify below whether the proposal requires new or amended services: | | | a) Gas | Yes ☐ No ☐ | | b) Electricity | Yes ☐ No ☐ | | c) Water | Yes ☐ No ☐ | | d) Telecommunications | Yes ☐ No ☐ |
The applicant should consult the service providers separately in order to establish the location of existing services and the impact of the proposed works on existing services. See guidance notes.
| | | | --- | --- | | b) How will foul sewage from the proposed development be disposed of? | | | c) If a septic tank/Biodisc system is proposed, please provide details demonstrating that the septic tank/Biodisc would be acceptable under Building Regulations — See guidance notes. | | | 15. a) Are there any trees on or within 15m of the proposed development site with a stem diameter of 75mm or more, measured at 1.5m above ground level? | Yes ☐ No ☐ | | b) Are there any large shrubs or hedges on the proposed development site? | Yes ☐ No ☐ |
If you answered 'Yes to either of the above, then your application will need to include a level of tree related information appropriate to the proposed development, which in some circumstances (e.g. change of use) may mean that no additional information is required. Please refer to the guidance document, 'Trees and the planning process – Part 1' for further guidance. You must provide details of any trees which are to be 'topped' or 'felled' as a result of the proposal.
| | | | --- | --- | | 17. Are the activities Retrospective or a result of an Enforcement Enquiry? If as a result of an enforcement enquiry please quote reference and the date that the building work or use was started/completed. | Yes ☐ No ☐ | | Enf No. | Started | | 18. Have you received pre-application advice from a Planning Officer? If yes, please state the Officer's name and the date of their response. | Yes ☐ No ☐ | | In any assessment of this application please be aware that the Case Officer may undertake to visit the site to ensure 1) the site notice has been correctly placed/erected, 2) check the application content against the proposed work / site levels 3) speak to neighbours, if they feel it relevant, and 4) Take photographs where necessary. | |
| | | | --- | --- | | Building Regulations | | | 19. Are you making a concurrent application for Building Regulations Approval? | Yes ☐ No ☐ |
PA Form 2.1(i)

This certificate provides confirmation that the owner of the land which is the subject matter of the application is either the applicant or is fully aware of the application.
The certificate constitutes a statement of ownership and is not proof of ownership.
The applicant is requested to complete either Statement A or Statement B and return the completed certificate along with the planning application form and any supporting documents.
NO APPLICATION WILL BE PROCESSED UNTIL SUCH TIME AS THE CERTIFICATE IS SUBMITTED.
I certify that the accompanying application is made by the benefit of the owner of the land, namely:
VOTE / TRENCE / KNOWLEDGE
(Full names in CAPITAL letters)
who is:
(a) the full* / limited* owner of the freehold* / leasehold* estate in the land (*delete as appropriate); and
(b) in full possession of every part of the land to which the application relates.
If the application is made on behalf of the land owner, a certified copy of the power of authority signed by the owner authorising the application on his behalf is attached hereto.
I certify that appropriate written notice of the accompanying application has been given by or on behalf of the applicant to:
(a) the land owner (referred to in statement A of this certificate); and
(b) to any person who at the time of the making of the application was:
(i) a person then in actual possession
(ii) the trustee of a trust or settlement if a beneficiary under the trust or settlement was in actual possession and no person other than such a beneficiary was entitled to enter into actual possession within a period of 40 years; and
(iii) a person, not being a person falling within (a) or (b) (i) and (ii), entitled to enter into actual possession within a period of 40 years.
The persons upon whom notice was issued are
| Name & Address | | Name & Address | | | --- | --- | --- | --- | | | | | | | Interest | | Interest | | | Date notified | | Date notified | | | Signature Applicant/Agent | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Planning and Building Control Directorate, Department of Environment, Food and Agriculture | | | | | Murray House, Mount Havelock, Douglas, Isle of Man, IM1 2SF | | | | | Tel: +44 1624 685950 | | | | | Fax: +44 1624 686443 | | | | | Email: [email protected] | | | | | | | | | | | | | | | | | | | | Putting the Customer First | | | | | Certificate 01(i) | | | |
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