FOR OFFICIAL USE

FORM TCP/ 1

Application Received: ………………………………………………

Signed: ………………………………………………………………

Reference No: ……………………………………………………….

Acknowledgement Sent……………………………………………...

MINISTRTY OF FINANCE AND PLANNING

APPLICATION FOR PERMISSION TO DEVELOP LAND

(The Town and Country Planning Act, Chap. 35:01)

To: MINISTER OF FINANCE AND PLANNING

I/We hereby apply for permission to carry out development described in the application and on the attached plans
and drawings.

Signed …………………………………………………

Dated …………………………………………………..

c/o Town and Country Planning Division,

NOTE TO APPLICANTS

1. Has any previous application for Planning been made for any part of the lands or Yes No
building which are the subject of this application?

If Yes state the Registration Number ……………………………… And Whether Outline Or Final

2. NATURE OF DEVELOPMENT tick ( ) New Buildings Additioin to Existing Structure

Alteration Change of Use Sub-division

3. * APPLICATION SEEKING APPROVAL FOR Section 1.0 only

BUILDING OPERATIONS AND CHANGE OF USE
(New buildings, additions and alterations) must fill out -

4. *APPLICATION SEEKING APPROVAL FOR Section 2.0 only

SUD-DIVISION OF LAND MUST FILL OUT

* Omission or falsification of any information required in this form may invalidate the application.
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DETAILS OF APPLICATION

A. Applicant
1. SURNAME ……………………………………………………………………………………………………………………

2. CHRISTIAN OR OTHER NAMES …………………………………………………………………………………………..

3. ADDRESS (POSTAL) ………………………………………………………………………………………………………..

………………………………………………………… 4. TELEPHONE No. ………………….

5. Is the applicant, owner Lease Tenant Prospective Purchaser , of the land / building

*B. Owner, (if applicant is not owner, state)

1. NAME ………………………………………………………………………………………………………………………

2. ADDRESS ………………………………………………………………………………………………………………….

…………………………………………………………… 3. TELEPHONE No. ………………….

* NOTE: Proof of ownership or evidence of notification to owner that present application is being made may be required.

C. Land

1. LOCATION: a. County …………………………………………………. b. Ward ………………………………………

c. Town or Village ……………………………………………………………………………………………

d. Street ………………………………………………….. e. Lot No. …………………………………..

2. REFERENCE: a. Assessment Roll No. ………………………………….. b. Unique Ref No. …………………………..

SKETCH PLANE (For Official Use)

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SECTION 1.0 BUILDING OPERATIONS

General : State reference number of approval sub-division layout …………………………………………………………………...

1.1 Is there a building on the site? Yes No

1.11. If so, state present use (see classification below) …………………………………………………………………………

1.12. Is the building to be demolished Yes No

1.2. INTENDED use of Excisting / Proposed * building:

(a) Residential …. …. …. …. (i) Single family

(ii) Multiple family

(b) Mixed use …. …. …. …. (i) Resendential/ Professional

(ii) Resendential/commercial

(c) Business …. …. …. …. (i) Commercial

(ii) Industrial

(d) Institutional …. …. …. …. …. …. …. ….

1.3 (i) TOTAL SITE AREA ……………………………………………………………………………………………...…………

TOTAL FLOOR AREA ……………………………………………………………………………………………………..

1.4. SERVICE:
Are the following available on site?

(i) Electricity Yes No (ii) Piped Water Supply Yes No

If No, Specify Source ………………………………………………………………………………………………………..

1.5 DRAINAGE :

State details of existing or proposed

(i) surface drainage (storm) ……………………………………………………………………………………………………..

(ii) foul drainage (sewage) W.A.S.A. Septic tank

Pit Latrine Other (state) ………………….

*Delete whichever is not applicable

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ANY CHANGE OF USE

II. For Residential Use

Floor Area (sq. metres)

1.6 Type of Dwelling Unit Number of each Unit Total Floor Area (sq. metres)

(a) Bed sitter … … …...…………………………………………………………………………

(b) One bedroom … … .…....………………………………………………………………….…….

(c) Two bedroom … … …..………………………………………………………………………….

(d) Three bedroom … … ……..………………………………………………………………………

(e) Four bedroom … … ……..….…………………………………………………………………...

(f) Four + bedrooms … … …...………………………………………………………………………...

TOTAL No. OF UNITS … ……………………………………………………………………………...

1.7 Off Street parking space (including garages and carports): No……………….. Area……..…....(sq. metres)

III. For Mixed Use

1.8 Floor Area (sq. metres) devoted to each use Residential …………………………….………………………………….

Professional …………………….. Commercial ………………………….

N.B – Applicants for mixed use must also fill out Item 1.13.

IV. For Commercial and Industrial Use

1.9. Nature of proposed business: Office Shop Factory Other ……………………………

1.10. Proposed No. of employees on completion of development …………………….………………………………………………………….

1.11. Description of Process to be carried on …………………………………………………………………………………………………….

……………………………………………………………………………………………………………………………………………….

1.12. Composition of Trade Refuse and Efficient and means of disposal ………………………………………………………………………...

………………………………………………………………………………………………………………………………………………..

1.13 Off-street Loading/unloading and Parking for commercial, Industrial and mixed use.

On site Off-site No. Area

(a) Parking … … ………………………………………………………………………………………..

(b) loading/unloading … … ……………………………………………………………………………………….

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SECTION 2.0 SUB-DIVISION OD LAND

2.1 Design of Layout prepared by: Name ………………………………………………………………………...

Designation …………………………………………………………………..

2.2 (i) Total Area of Property ……………………………………………… hectares ……………………….sq. metres

(ii) Area of Portion to be Sub-divided ……………………………….…. hectares ………………....…… sq. metres

2.3 Adjacent Property Owners North ………………………………….. East ……………………………….

South …………………………………. West ……………………………...

2.4 Breakdown of proposed plots:

Type No. Area

(a) Residential …… … … ………………………………………………………………………

(b) Commercial … … … ………………………………………………………………………

(c) Industrial … … … ………………………………………………………………………

(d) Institutional … … … ………………………………………………………………………

(e) Public Open Space … … ………………………………………………………………………

(f) Agriculture … … ………………………………………………………………………

2.5 Present land use … … … ………………………………………………………………………

2.6 Is there an existing access to the site Yes No

2.61. If so state (i) name of road ……………………………………… (ii) Width …………..………

(iii) nature and condition of the surface ………………………………………………………..

……………………………………………………………………………………………...

2.62. If not (or existing access is to be altered) state,

(i) proposed width of reservation of new road ……………………………………………….

(ii) location in relation to nearest existing roads ……………………………………………..

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OFFICIAL USE ONLY

Registered Reference No. …………………….. Date Received …………………….... Approved Date ………………

Previous Applications ………………………… Map Record Sheet No. ……………… Refused Date ………………...

A. Suitability of Site

Natural Conditions of Site Factors:

*topography *drainage

*soil *geology

B. Present Use and Proposals

C. Appropriateness of Development

C.1. Compatibility of Use

Present Zoning ……………………………………………. Proposed Zoning …………………………………………

C.2. Intensity of Development

Floor Area Ratio 4ii ………………………………………. Plot Coverage …………………………………………….

4i

Density of housing (Dwelling Units per Gross Hectares) …………………………………………………………………...

Density of Sub-division Development (lots per gross hectares) …………………………………………………………….

(min. size of lot per family) ………………………………...………………………………

D. Adequacy of Development
Proposals if
Not Adequate

D.1. Adequacy of Sub-division

(i) Layout …………………………………………………………………………………………………………………..

(ii) Shape and Size of Lots………………………………………………………………………………………………….

D.2. Adequacy of Services

(i) Surface Drainage ………………………………………………………………….…………..…………..……………

(ii) Foul Drainage …………………………………………………………………………………………………………..

D.3. Adequacy of Access and Parking…………………………………………………………………………………………………………….

D.4. Adequacy of Disposal of refuse and Trade Effluent Disposal …………………………………………………………………..