APPLICATION FOR LAND DRAINAGE CONSENT
FOR WORKSAFFECTING ORDINARY
WATERCOURSES
Flood and Water Management Act 2010
Environment Act 1995
Land Drainage Act 1991
Water Resources Act 1991
Highways Act 1980
IMPORTANT NOTE. Please read this form and the attached notes carefully before you fill it in. Please take care answering the questions. If the form is completed properly it will mean that your application will be dealt with more quickly. If you have any queries, please contact us on 01332 641789
DETAILS OF APPLICANT
NAME
CONTACT PERSON
POSTAL ADDRESS
TELEPHONE
EMAIL
AGENTS DETAILS (IF APPLICABLE)
NAME / PROFESSION
ADDRESS / CONTACT (PERSON DEALING WITH APPLICATION)
POST CODE / TELEPHONE
EMAIL
APPLICANTS INTEREST IN LAND
(FOR EXAMPLE ARE YOU THE OWNER / CONTRACTOR / CONSULTANT?)
LOCATION
LOCATION OF PROPOSED WORKS
(PLEASE NOTE YOU ARE REQUESTED TO INCLUDE A SUITABLE SITE PLAN)
OS GRID REFERENCE:
NAME OF RIVER / WATERCOURSE (IF KNOWN):
PARISH COUNCIL (IF KNOWN):
DESCRIPTION OF PROPOSED WORKS
NUMBER OF STRUCTURES
DESCRIPTION AND REFERENCE NUMBERS OF PLANS, SECTIONS AND PHOTOGRAPHS SUBMITTED
CONSTRUCTION DETAILS
STATE WHETHER WORKS ARE TO BE PERMANENT OR TEMPORARY
IF TEMPORARY, STATE DURATION REQUIRED
FOR ALLWORKSSTATE ANTICIPATED CONSTRUCTION START DATE
ENVIRONMENT AGENCY INTERESTS
DO THE PROPOSED WORKS INVOLVE OR AFFECT:
YES / NO
a) DISCHARGE OF TRADE EFFLUENT
b) DISCHARGE OF SURFACE WATER
c) AN IMPOUNDMENT OF A WATERCOURSE
d) ABSTRACTION OF WATER
e) FISH OR FISHERIES
f) THE DISPOSAL OF WASTE MATERIAL
PLEASE TICK ALL APPROPRIATE BOXES
IF YOU HAVE TICKED YES TO ANY OF THE ABOVE YOU ARE REPONSIBLE FOR CONTACTING THE ENVIRONMENT AGENCY FOR THE APPROPRIATE CONSENTS AND / OR PERMISSIONS
IF PLANNING APPROVAL HAS BEEN GRANTED STATE:
APPLICATION NO.
DESCRIPTION OF SCHEME
APPROVAL DATE
NAME OF PERSON OR ORGANISATION RESPONSIBLE FOR MAINTAINING THE STRUCTURE UPON COMPLETION
BRIEF DETAILS OF ENVIRONMENTAL IMPACT OF WORKS TOGETHER WITH ANY PROPOSALS FOR AMELIORATION AND / OR COMPENSATORY ENHANCEMENT
DECLARATION
I / We
  1. Apply for consent to carry out works as described in this application form and associated plans and calculations
  2. Will, within 7 days of submitting this application, make the necessary payment to Derby City Council in order for the application to be considered valid and then considered.
  3. Enclose plans sufficient to show clearly the location of the proposed works together with plans and sections showing details of the proposed works. These are to a scale appropriate to the nature of the works and include relevant calculations.

Signed
On behalf of
Date
Please return this form and any attachments by email to /

Alternatively send by post to / Derby City Council
Projects Water and Flood Defence Team
15 Stores Road
Derby
DE21 4BD
OFFICIAL USE ONLY
YES / NO
ORDINARY WATERCOURSE / DATE APPLICATION RECEIVED:
FEE RECEIVED / DATE FEE RECEIVED:
FILE REFERENCE
DerbyCity Council Watercourse Consent Application / Page 1