# Apeak I I D I S T R I C T National Park Authority Householder Application For Planning Permission For Works Or Extension To A Dwelling. Town And Country Planning Act 1990

## Publication Of Planning Applications On Council Websites

Please note that with the exception of applicant contact details and Certificates of Ownership, the information provided on this application form and in supporting documents may be published on the council's website. 

if you have provided any other information as part of your application which falls within the definition of personal data under the Data Protection Act which you do not wish to be published on the council's website, please contact the council's planning department. 

Please complete using block capitals and black ink. 

It is important that you read the accompanying guidance notes as incorrect completion will delay the processing of your application. 

## 3. Descriptionof Proposed Works

Please describe the proposed works: 

## 2. Agent Name And Address 3. Description Of Proposed Works (Continued)

Has the work already started? 
Has the work already been completed? 

## 4. Site Address Details 6. Pre-Application Advice

Has assistance or prior advice been sought from the local 
authority about this application? 
«p^TYes 
I I No 
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). 
8. Parking 
Will the proposed works affect 
existing car parking arrangements? 

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

Yes 
Is a new or altered vehicle access proposed to or from the public highway? 
Yes 
Is a new or altered pedestrian access proposed to or from the public highway? Do the proposals require any diversions, 
extinguishments and/or creation of public 
rights of way? 
If Yes to any questions, please show details on your plans or 
drawings and state the reference number(s) of the plan(s)/ drawing(s): 

## 7. Trees And Hedges

Are there any trees or hedges on your own 
property or on adjoining properties which 
^ ^ 
are within falling distance of your boundary? [ ] ] Yes 
Q
^ 
If Yes, please mark their position on a scaled 
plan and state the reference number of any plans or drawings: 
Will any trees or hedges need 
to be removed or pruned in 
order to carry out your proposal? 
|                                                                     | If       |  Yes,   |  please show on your plans which trees by giving them    |
|---------------------------------------------------------------------|----------|---------|----------------------------------------------------------|
| numbers                                                             | e.g.     | Tl,     | T2 etc, state the reference number of the plan(s)/       |
| drawing(s) and indicate the scale.                                  |          |         |                                                          |
| 9. Council Employee / Member                                        |          |         |                                                          |
| is the applicant or agent related to any member of staff or elecj^d |          |         |                                                          |
| member of the council?                                              | !""] Yes |         | \~^\\r^                                                  |
If Yes, please provide details: 

## 10. Materials

If applicable, please state what materials are to be used externally. 1 ndude type, colour and name for each material: 

Proposed 
Don't 
Know 
Existing (where applicable) 
Drawing references if 
applicable 
Not 
applicable 
s) 
1 - I 
Walls 
r - i 
Roof 
i 
^ Windows 
1 1 
Doors 
1 ' 
1
- 
Boundary treatments (e.g. fences, walls) 
1 1 
-
—
^ 
. 
Vehicle access and 
Whard-standing 
1 ' 
/ 
Lighting 
—
^ 
y T 
1 j 
Others 
(please specify) 
—
1 
Are you supplying additional information on submitted plan(s)/drawing(s)/design and access statement? 
^ " T e l 
No 
If Yes, please state references for the plan(s)/drawing(s)/design and access statement: 
^c^^cH/f^j^s• m ^ Fia^t^. 

## 11. Certificates

One Certificate A, B, C, or D, must be completed, together with the Agricultural Holdings Certificate with this application form 

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 freeholdinterest or leasehold interest with at least 7 years left to run) of any part of the land or building to which the application relates. 

Signed-^licant: 
Or signed - Agent: 
Date (DD/MM/YYYY): 
% H m 

i certify/The applicant certifies that I have/the applicant has given the requisite notice to everyone else (as listed below) who, on the day 
21 days before the date of this application, was tiie 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 this application relates. 

Name of Owner 
Address 
Date Notice Served 
| Signed -Applicant:    | Or signed - Agent:    | Date (DD/MM/YYYY):    |
|-----------------------|-----------------------|-----------------------|

I certify/ The applicant certifies that: 
- 
NeitherCertificate A or Bean be issued for this application 

- 
All reasonable steps have been taken to find out the names and addresses ofthe other owners (owner is a person with a freehold 
interest or leasehold interest with at least 7years left to run) of the land orbuilding, orof a part of it, but I have/the applicant has been 
unable to do so. 

The steps taken were: 
Name of Owner 
Address 
Date Notice Served 
Notice ofthe application has been published in the following newspaper 
(circulating in the area where the land is situated): 
On the following date (which must not be earlier 
than 21 days before the date ofthe application): 

Sighed-Applicant: 

I certify/ The applicant certifies that: 

- 
Certificate A cannot be issued for this application 
- 
All reasonable steps have been taken to find out the names and addresses of everyone else who, on the day 21 days before the 
date of this application, was the owner (owner is a person with a freehold interest or leasehold interest with at least 7years left to run) of any partoftheland to which this application relates, but I have/the applicant has been unable to do so. 
The steps taken were: 
(circulating in the area where the land is situated): 

## Agricultural Holdings Certificate Town And Country Planning (General Development Procedure)Order 1995 Certificate Under Article 7 Agricultural Land Declaration - You Must Complete Either A Or B

t^ mu 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 ofthe land to which this application relates, as listed below: 

Name of Tenant 
Address 
Date Notice Served 

## 12. Planning Application Requirements - Checklist

Please read the following checklist to make sure you have sent all the information in support of your proposal. Failure to submit all information required will result in your application being deemed invalid. It will not be considered valid until all information required by the Local Planning Authority has been submitted. 

The original and 3 copies of a completed and dated application form: 

| The original and 3 copies of                 |  a     |  plan which    |
|----------------------------------------------|--------|----------------|
| identifies the land to which the application |        |                |
| relates drawn to an identified scale         |        |                |
| and showing the direction of                 | North: |                |
| The original and 3 copies of other plans     |        |                |
| and drawings or information necessary to     |        |                |
| describe the subject ofthe application:      | []]    |                |
| The original and 3 copies of                 | a      |                |
| design and access statement where            |        |                |
| proposed works fall within one of            |        |                |
| the following designated areas:              |        |                |
| - National Park                              |        |                |
| - Site of special scientific interest        |        |                |
| - Consen/ation area                          |        |                |
| - Area of outstanding natural beauty         |        |                |
| - World Heritage Site                        |        |                |
| - The Broads                                 |        |                |

## 13. Declaration L/We Hereby Apply For Planning Permission/Consent As Described In This Form And The Accompanying Plans/Drawings And Additional Informatic

than 21 days before the date ofthe application): 
The original and 3 copies ofthe 
I I 
completed, dated Article 7 Certificate 
(Agricultural Holdings): 

n 

The original and 3 copies ofthe 
completed, dated Ownership Certificate 
(A, B, C or D - as applicable): 

(date cannot be pre-application) 
l')km(