IMPORTANTThis notice must be submitted at least six weeks prior to the proposed demolition. Failure to do so is a contravention of the above Act and may result in prosecution. Mandatory fields have a yellow background and are marked with a "*" Address of building(s) to be demolished Property Name * Street Name * Town * Postcode * Name and Address of Owner Title Mr Mrs Miss Ms Dr Sir * Forename * Surname * Property Name or No * Street * Town * County * Postcode * Telephone * Name and Address of Agent Name Property No. or Name Street Town County Postcode Telephone Name and Address of Demolition Contractor Name * Property No or Name * Street * Town * County Postcode * Tel No (office hours) * Tel No (other) * Name and Address of Keyholder if Premises are Vacant Name Property No. or Name Street Town County Postcode Telephone Type/Method of Demolition to be used Please give details (method statement required) * What Services are to be Disconnected? Gas Yes No * Water Yes No * Electricity Yes No * Telephone Yes No * Other ....... Additional Information Does the building contain any form of dangerous or offensive materials eg. asbestos, stored chemicals, combustible/inflammable/explosive materials etc; Yes No * If so has the Health and Safey been notified Yes No * If Yes, please indicate the date of notification Do you intend to burn any part of the structure or materials on site? Yes No * If Yes, please give details Intended commencement date Please state the contract period of demolition * Please state how many dwellings (if any) are to be demolished ? *
IMPORTANTThis notice must be submitted at least six weeks prior to the proposed demolition. Failure to do so is a contravention of the above Act and may result in prosecution. Mandatory fields have a yellow background and are marked with a "*"
Address of building(s) to be demolished
Town
Postcode
Name and Address of Owner
Title
Mr Mrs Miss Ms Dr Sir *
Forename
Surname
County
Name and Address of Agent
Name
Property No. or Name
Street
Telephone
Property No or Name
Tel No (office hours)
Tel No (other)
Name and Address of Keyholder if Premises are Vacant
Type/Method of Demolition to be used
Please give details (method statement required)
*
What Services are to be Disconnected?
Gas
Yes No *
Water
Electricity
Other .......
Additional Information
Does the building contain any form of dangerous or offensive materials eg. asbestos, stored chemicals, combustible/inflammable/explosive materials etc;
If so has the Health and Safey been notified
If Yes, please indicate the date of notification
Do you intend to burn any part of the structure or materials on site?
If Yes, please give details
Intended commencement date
Please state the contract period of demolition
Please state how many dwellings (if any) are to be demolished ?
A copy of this completed notice should be sent to the local gas and electricity offices (as appropriate) and to the occupiers of any adjacent buildings.You should forward seperately a site plan to a scale of not less than 1:1250 showing the position of the building(s) to be demolished and the boundaries of the site.The plan should indicate drainage details of both foul and surface water that are :- a. to remain in use b. to be discontinued and grubbed upIt should also state the method of sealing redundant drainage/inspection chambers (if any). The completed plan should be sent to :
Wyre Forest District CouncilPlanning and Environment DivisionBuilding Control SectionDuke HouseClensmore StreetKidderminsterWorcestershireDY10 2JX