Read Job Application Form text version

CWLIDB Form: E1 - Application for Land Drainage Consent (Issue 6) December 2008

Application for Land Drainage Consent

(Please tick relevant Board for your area)

LAND DRAINAGE ACT 1991 & 1994

Caldicot & Wentlooge IDB Lower Wye IDB

Powysland IDB River Lugg IDB

West Mendip IDB

If you have any queries please contact us before submitting your Application. Please complete in block letters using BLACK INK

A fully & accurately completed form will greatly assist the Board in processing your Application quickly.

Please take care when answering the questions on this form.

IMPORTANT NOTE:

1.

Name:

Details of Applicant

Address:

Contact (if different): Daytime Tel. No: Mobile No: Fax No:

Post Code:

E-mail Address:

2.

Name:

Agents Details (e.g. Consultant Land Agent - if applicable)

Profession: Address:

Contact:

Daytime Tel. No: Mobile No: Fax No:

Post Code:

E-mail Address:

3.

Applicants Interest in the Land

4.

District Council/Unitary Authority: Parish/Community Council: Ordnance Survey Grid Ref:

Name of Watercourse (if known):

Location of Proposed Works:

Location

5.

Description & Purpose of Proposed Works

Number of Structures:

6.

Description & Reference Number of all Plans & Sections Submitted

7.

State whether works are to be permanent or temporary: If temporary, state duration required: For all works, state anticipated construction start date:

Construction Details

8.

In addition to the works listed in Section 7., do the purposed works involve the following: Yes No Discharge of effluent?

Other Interests

An impounding of a watercourse?

Discharge of surface water?

Abstraction of water from a watercourse?

Please tick appropriate boxes

Construction or landscaping works (temporary or permanent) adjacent to a watercourse?

(A further Consent may be required from the Board)

9.

Planning Authority: Application No: Approval Date: Conditions:

If Planning Approval has been granted please state:

10.

Name:

Name, Address & Contact Details of Person or Organisation Responsible for Maintaining the Structure on Completion

Contact: Daytime Tel. No: Mobile No: Fax No:

Profession: Address:

Post Code:

E-mail Address:

11.

Brief Details of Environmental Impact of Works Together with any Proposals for Amelioration and/or Compensatory Enhancement

12.

Brief Details of Flood Risk Considerations together with any Proposals for Mitigation

13.

I/We: 1. 2.

The Board, by granting Consent under the Land Drainage Act 1991 for these works, accepts no liability for any loss or damage which may arise out of their design, construction, maintenance or use. Apply for consent to carry out works as described in this Application Form and on the attached plan(s) Enclose x 2 copies of the Application Form x 2 copies of Site/Area Plans x 2 copies of Detail Plan with Sections x 1 Application Fee - £50.00 per structure Name:

(Please make cheque payable to the applicable Board)

Declaration

Signed: Date:

On behalf of: Please return the Application Form to: The Clerk & Engineer to the Board Caldicot &Wentlooge Levels IDB Pye Corner, Broadstreet Common Nash, Newport NP18 2BE

Further information may be obtained from the above office or via:

Information

Job Application Form

4 pages

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