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Please complete in BLOCK CAPITALS and in black ink.
For office use only
The person here below named as the applicant is responsible for payment of the appropriate fee.
For office use only
Date: 7-5-65
Receipt number: 915738
All relevant questions on this form must be answered.
20000000175
a) Full name of Applicant
b) Address of Applicant
Telephone number
Applicant E-Mail Address
a) Full name of Agent
b) Address of Agent
Telephone number
Agent E-Mail Address
Name and address of owner of site if different from the applicant.
Please provide the name and address of any other person known to have an interest in the land and indicate whether any such other person has been notified of the application.
What is the Applicant's interest in the site? (e.g. owner, potential purchaser etc.)
Under which of the following paragraphs of Section 24(1) of the 1999 Act is this application made?
If yes, please state the date the use started.
And name the use class applicable now.
b) To make lawful a proposed use of the buildings or land?
If yes, please state the current or last know use of the land.
Continue overleaf
Putting the Customer First
c) To make lawful operations which have been carried out in, on, over or under the land? Yes \square No \square If yes, 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. d) To make lawful operations proposed to be carried out in, on, over or under the land? e) To make lawful a failure to comply with any condition subject to which planning approval was granted? If yes, please state the date on which the matter constituting the failure occurred and quote the planning application number, or sufficient detail in order for it to be identified. 7. On a separate sheet 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. The Department of Environment, Food & Agriculture is a data controller for the purposes of 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 The Town and Country Planning (Certificates of Lawful Use or Development) Regulations 2005. 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. We will only keep these details for as long as we require them, and in accordance with 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 processes your personal information are contained in our The Data Protection Officer can be contacted on 686781 or by email at [email protected] I/We the named applicant(s) hereby apply for a certificate of lawfulness, in respect of the matters set out above and in accordance with the information submitted herewith.
Signature of Applicant
I herewith enclose:
It is requested that three copies of this application form and all supporting statements and plans are forwarded to the address below.
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 issue a Notice to the Local Authority and any such person as noted in answer to section 4 of this form. The Notice will invite written representation as to the content of the application. If necessary the Department will advertise this application by way of the weekly planning publication list. 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: a) on summary conviction to custody for a term not exceeding 6 months or to a fine not exceeding £ 10000, or both; b) 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.
Planning and Building Control Directorate, Department of Environment, Food and Agriculture, Murray House, Mount Havelock, Douglas, Isle of Man, IM1 2SF Tel: +44 1624685950 Fax: +44 1624686443 Email: [email protected]
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