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Form. AIRC22.0 The Town and Country Planning Act 1999 The Town and Country Planning (Development Procedure) Order 2019 Application for Information Required By Condition Form Continue overleaf 5. Please detail the condition(s) to be addressed with this application 1. Site Address (the site address of this amendment MUST match that of the existing approval). 3. a) Full name of Agent (if any) b) Address of Agent Telephone number 4. Reference number of the planning approval of application b) Address of Applicant Telephone number Home Work 2. a) Full name of Applicant Applicant E-Mail Address Agent E-Mail Address 6. Please detail the information provided: Please complete in BLOCK CAPITALS and in black ink. This form can be submitted by email to [email protected] with all supporting documents attached or delivered to our public counter. All relevant questions on this form must be answered. 7. Has the development already started? Yes No If Yes, please state when the development started (DD/MM/YYYY): (date must be pre-application submission) Has the development been completed?

Yes No If Yes, please state when the development was completed (DD/MM/YYYY): (date must be pre-application submission) FIELD 321028, ELLERSLIE FARM, OLD CHURCH ROAD, CROSBY, ISLE OF MAN SURE IOM LTD FOURTH FLOOR, ATLANTIC HOUSE, DOUGLAS, IM1 1AG 01624692206 [email protected] NA NA NA NA 23/01176/B CONDITION 3 PLEASE SEE SEPERATE DOCUMENT DETAILING EQUIPMENT TO BE INSTALLED

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Form AIRC22.0 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 Department of Environment, Food & Agriculture (DEFA) is a controller for the purposes of the Data Protection Act 2018 and related legislation (and its subsequent legislation) and requires the information supplied by this application in the public interest to comply with obligations under the Town and Country Planning Act 1999 and its subordinate Orders and Regulations. Any personal information will be held by the DEFA for the purposes of processing this application to ensure compliance with the provisions of the Town & Country Planning Act 1999 Some of the information you provide such as the applicant name, and address will be shared at our public counter, with the Local Authority and as part of the application image via our online service. We will only keep these details in accordance with the appropriate application under the Town and Country Planning Act 1999. Full details of how and why DEFA processes your personal information are contained in our P&BC Privacy Notice If you would like further information on how your personal information is processed and your rights please contact the Department’s Data Protection Officer on 686781 or by email at [email protected] Signature of Applicant or Agent Date I/We the named applicant(s) hereby apply for satisfaction/discharge of a planning condition, in respect of the matters set out above and in accordance with the information submitted herewith. Capacity (if signing on behalf of a company, please state clearly your relationship) 7. Statement I have enclosed the following: · This application form · All supporting documentation relating to the discharge of listed conditions · A schedule of drawings