Requisition a Water Main

Transcription

1 Please ensure you have read our guidance notes before completing this application form and include as much information as possible. If mandatory fields (marked with a ) are not completed this could result in your application being returned. 1. Applicants Details Company Name Contact Name House Number/Name Street Town County Post Code Contact Telephone Number(s) address 2. Name and address of agent (if any) Company Name Contact Name House Number/Name Street Town County Post Code Contact Telephone Number(s) address

2 3. Development details What is the nature of your proposal? Name of development House Number/Name/Plots Street Town County Post Code National Grid Reference e.g. ST Planning Approval Is the development planning exempt? If, please state why Planning Approval Reference If Planning Permission is required for your development, please supply the Planning Approval Reference Number(s) 5. Previous use/use of premises Was there a premise(s) on the site in the previous 5 years? If, please give details What is the intended use of the development? Agricultural Commercial Industrial Residential Other Tick If Other please specify e.g. School, Hospital etc

3 6. Previous use of land What was the previous use of the development? What is the current use of the development? Is the new water supply required for a development on a Brownfield site? Has the site or any adjacent sites or other land through which you propose to lay your water pipe(s) potentially be affected by contamination? Are you planning to store any chemicals, fuel or other materials likely to affect the quality of wholesome water and which will affect the proposed pipe selection? Brown Field Site - Construction of new properties or renovations/conversions of existing buildings, land or premises that have previously been used or developed and may be vacant or derelict Brown Field Site - Construction of new properties or renovations/conversions of existing buildings, land or premises that have previously been used or developed and may be vacant or derelict 7. Description of proposed works Water Supply (Water Fittings) Regulations 1999 tification of Proposed Works for the Granting of Consent. This section does not have to be completed if you are separating a domestic shared supply. For help with completion of this section, please refer to our Guidance te in Section 7. The installation of water fittings in conjunction with: The erection of a building or other structure Extension or alteration of a water system on any premises A material change of use of the premises Temporary standpipe Other installation

4 8. Proposed Installations If any of the question in this section have been answered, you must provide supporting documentation i.e. Installation plans, diagrams, technical details of fittings/appliances, make/model etc and any relevant approval documents Does your proposal development include: A bidet with an ascending spray or flexible hose A pump or booster drawing more than 12 litres per minute, connected directly or indirectly to a supply pipe e.g. Pumped delivery showers (power showers), pressure washers, high rise building pumped water delivery systems A water treatment unit which incorporates reverse osmosis e.g. Pure water system A water treatment unit which produces a wastewater discharge or which requires the use of water for regeneration of cleaning e.g. Certain types of domestic/commercial salt regenerated water A reduced pressure zone (RPZ) valve assembly or other mechanical device for fluid category 4 backflow protection A garden watering system, unless designed to be operated by hand Any water system laid outside a building, either less than 750mm or more than 1350mm below ground The construction of a pond or swimming pool over 10,000 litres capacity, designed to be replenished automatically with water Any water pipes for fire fighting purposes A rainwater or greywater harvesting system Use of an alternative supply of water anywhere on the premises e.g. Spring, borehole etc 9. Land interest What is your interest in the land to be served by the requisitioned main? Owner Occupier Local Authority Hold an option to buy Tick

5 10. Pre-Planning Has your site been subject to a pre-planning enquiry? Pre-planning reference number Date Pre-Planning advice issued 11. Phasing information for the Installation of a Water Main The extent of each phase is to be marked on a site plan Phase Total Plots Anticipated date of 1st occupation Number of properties by the end of Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Year 12 Phase Number

6 Legal tice Terms and Conditions - I confirm that I have read and agree to the terms and conditions of this application Legal tice - This application constitutes a notice under section 45 of the Water Industry Act 1991 Tick Signed Print Name Date