## Application For Planning Permission. Town And Country Planning Act 1990

Publication of applications on planning authority websites.  
Please note that the information provided on this application form and in supporting documents may be published on the Authority's website. If you require any further clarification, please contact the Authority's planning department.

## 1.  Applicant Name, Address And Contact Details

Company name
Country Code
National Number
Extension Number
Telephone number:
Great Hucklow
Mobile number:
Town/City
Buxton
Fax number:
County:
Derbyshire
Email address:
Country:
UK
Postcode:
SK17 8RF

Are you an agent acting on behalf of the applicant?

## 2.  Agent Name, Address And Contact Details

First Name:
Simon Surname:

| Company name:     | SJ Design Ltd          |
|-------------------|------------------------|
| Street address:   | The Old Co-Op Building |
| National          |                        |
| Number            |                        |
| Country           |                        |
| Code              |                        |
| Extension         |                        |
| Number            |                        |
| Telephone number: |                        |
| 01663 742903      |                        |
| Church Street     |                        |
| Mobile number:    |                        |
| Town/City         | Hayfield               |
| Fax number:       |                        |
| County:           | Derbyshire             |
| Email address:    |                        |
| Country:          | United Kingdom         |
| jonessj68@aol.com |                        |
| Postcode:         | SK22 2JE               |

## 3.  Description Of The Proposal

Please describe the proposed development including any change of use: Conversion of The Winding House to form a holiday let

Has the building, work or change of use already started?
No
Yes

## 4.  Site Address Details

(must be completed if postcode is not known):

## 5.  Pre-Application Advice

Has assistance or prior advice been sought from the local authority about this application?

If Yes, please complete the following information about the advice you were given (this will help the authority to deal with this application more efficiently):

## 6.  Pedestrian And Vehicle Access, Roads And Rights Of Way

Is a new or altered pedestrian access proposed to or from the public highway?
Are there any new public rights of way to be provided within or adjacent to the site?

## 7.  Waste Storage And Collection

Have arrangements been made for the separate storage and collection of recyclable waste?

## 8.  Authority Employee/Member

With respect to the Authority, I am: 
(a)  a member of staff 
 
(b)  an elected member 
 
(c)  related to a member of staff 
 
(d)  related to an elected member 

    Do any of these statements apply to you?

## 9.  Materials

Please state what materials (including type, colour and name) are to be used externally (if applicable):

Walls -  description:
Description of *existing* materials and finishes: N/A no new work anticipated Description of *proposed* materials and finishes: N/A no new work anticipated

## 9.  (Materials Continued)

Roof - description:
Description of *existing* materials and finishes: Blue Slate Description of *proposed* materials and finishes: Blue Slate
Windows - description:
Description of *existing* materials and finishes: Timber framed
Description of *proposed* materials and finishes: Timber framed
Doors - description:
Description of *existing* materials and finishes: Timber framed Description of *proposed* materials and finishes: Timber framed
Boundary treatments - description:
Description of *existing* materials and finishes: N/A Description of *proposed* materials and finishes: N/A
Vehicle access and hard standing - description:
Description of *existing* materials and finishes: Crushed stone Description of *proposed* materials and finishes: Crushed stone
Are you supplying additional information on submitted plan(s)/drawing(s)/design and access statement? 
No
Yes
If Yes, please state references for the plan(s)/drawing(s)/design and access statement: Drawings 100, 103, 105, 203 and 205. Design and access a character appraisal. Protected species form. Structural Survey.

## 10.  Vehicle Parking

Please provide information on the existing and proposed number of on-site parking spaces:
Type of vehicle
Existing number  
of spaces
Total proposed (including spaces 
retained)
Difference in  
spaces
Cars
4
5
1
Light goods vehicles/public carrier vehicles 
0
0
0
Motorcycles
0
0
0
Disability spaces
0
0
0
Cycle spaces
0
0
0
Other (e.g. Bus)
0
0
0
Short description of Other

## 11.  Foul Sewage

Please state how foul sewage is to be disposed of:
Mains sewer
Unknown
Package treatment plant
Septic tank
Cess pit
Other
Are you proposing to connect to the existing drainage system?
No
Yes
Unknown

## 12.  Assessment Of Flood Risk

Is the site within an area at risk of flooding? (Refer to the Environment Agency's Flood Map showing flood zones 2 and 3 and consult Environment Agency standing advice and your local planning authority requirements for information as necessary.)
No Yes If Yes, you will need to submit an appropriate flood risk assessment to consider the risk to the proposed site.

Is your proposal within 20 metres of a watercourse (e.g. river, stream or beck)?
No
Yes
Will the proposal increase the flood risk elsewhere?
No
Yes
How will surface water be disposed of?
Main sewer
Pond/lake
Sustainable drainage system
Existing watercourse
Soakaway

## 13.  Biodiversity And Geological Conservation

To assist in answering the following questions refer to the guidance notes for further information on when there is a reasonable likelihood that any important biodiversity or geological conservation features may be present or nearby and whether they are likely to be affected by your proposals.

Having referred to the guidance notes, is there a reasonable likelihood of the following being affected adversely or conserved and enhanced within the application site, OR on land adjacent to or near the application site: 

a) Protected and priority species
Yes, on the development site
Yes, on land adjacent to or near the proposed development
No
b) Designated sites, important habitats or other biodiversity features
Yes, on the development site
Yes, on land adjacent to or near the proposed development
No
c) Features of geological conservation importance
Yes, on the development site
Yes, on land adjacent to or near the proposed development
No

## 14.  Existing Use

Please describe the current use of the site: Dwelling House
Is the site currently vacant?
No
Yes
Does the proposal involve any of the following? If yes, you will need to submit an appropriate contamination assessment with your application. Land which is known to be contaminated?
No
Yes
Land where contamination is suspected for all or part of the site?
No
Yes
A proposed use that would be particularly vulnerable to the presence of contamination?
No
Yes

## 15.  Trees And Hedges

Are there trees or hedges on the proposed development site?
No
Yes
And/or: Are there trees or hedges on land adjacent to the proposed development site that could influence the development or might be important as part of the local landscape character?
No
Yes

If Yes to either or both of the above, you may need to provide a full Tree Survey, at the discretion of your local planning authority. If a Tree Survey is required, this and the accompanying plan should be submitted alongside your application. Your local planning authority should make clear on its website what the survey should contain, in accordance with the current 'BS5837: Trees in relation to construction - Recommendations'.

## 16.  Trade Effluent

Does the proposal involve the need to dispose of trade effluents or waste?

No Yes

## 17.  Residential Units

Does your proposal include the gain or loss of residential units?

No Yes

## 18.  All Types Of Development: Non-Residential Floorspace

Does your proposal involve the loss, gain or change of use of non-residential floorspace?

No Yes

## 19.  Employment

If known, please complete the following information regarding employees:

| Full-time          |   Part-time |   Equivalent number of full-time |
|--------------------|-------------|----------------------------------|
| Existing employees |             |                                  |
| 0                  |           0 |                                0 |
| Proposed employees |             |                                  |
| 0                  |           0 |                                0 |

## 20.  Hours Of Opening

If known, please state the hours of opening for each non-residential use proposed:

Use
Monday to Friday 
Start Time              End Time
Saturday 
Start Time              End Time
Sunday and Bank Holidays 
Start Time              End Time
Not 
Known

## 21.  Site Area

| hectares               |
|------------------------|
| What is the site area? |

## 22.  Industrial Or Commercial Processes And Machinery

Please describe the activities and processes which would be carried out on the site and the end products including plant, ventilation or air conditioning. Please include the type of machinery which may be installed on site: N/A

Is the proposal for a waste management development?
No
Yes

## 23.  Hazardous Substances

Is any hazardous waste involved in the proposal?

## 24.  Site Visit

Can the site be seen from a public road, public footpath, bridleway or other public land? If the planning authority needs to make an appointment to carry out a site visit, whom should they contact?  (Please select only one)

## 25.  Certificates (Certificate A) Certificate Of Ownership - Certificate A Town And Country Planning (Development Management Procedure) (England) Order 2010 Certificate Under Article 12 I Certify/The Applicant Certifies That On The Day 21 Days Before The Date Of This Application Nobody Except Myself/ The Applicant Was The Owner (Owner Is A Person With A Freehold Interest Or Leasehold Interest With At Least 7 Years Left To Run) Of Any Part Of The Land  Or Building To Which The Application Relates. 25.  Certificates (Agricultural Land Declaration) Agricultural Land Declaration Town And Country Planning (Development Management Procedure) (England) Order 2010 Certificate Under Article 12 Agricultural Land Declaration - You Must Complete Either A Or B (A)  None Of The Land To Which The Application Relates Is, Or Is Part Of An Agricultural Holding.

(B) I have/The applicant has given the requisite notice to every person other than myself/the applicant who, on the day 21 days before the date of this application, was a tenant of an agricultural holding on all or part of the land to which this application relates, as listed below: If any part of the land is an agricultural holding, of which the applicant is the sole tenant, the applicant should complete part (B) of the form by writing 'sole tenant - not applicable' in the first column of the table below

## 26.  Declaration

I/we hereby apply for planning permission/consent as described in this form and the accompanying plans/drawings and additional information. Date
31/01/2012