F7

Limerick City & County Council

Economic Development & Planning Department

DECLARATION ON DEVELOPMENT & EXEMPTED DEVELOPMENT

APPLICATION FORM
Section 5 Planning & Development Act, 2000-2014

ADMINISTRATIVE USE DATE RECEIVED: REFERENCE NO:

ONLY:

FEE RECEIVED: DATE DUE:

____________________________ ____________________________
Administrative Officer Date

All APPLICATIONS SHALL BE SENT TO:

Economic & Planning Development Department, Limerick City & County Council, 7/8 Patrick Street,
Limerick.

Telephone: 061-407210 E-mail: planning@limerick.ie

PLEASE ANSWER ALL QUESTIONS FULLY. QUESTIONS NOT ANSWERED MAY LEAD TO A
DELAY IN PROCESSING YOUR APPLICATION.

1. APPLICANT’S NAME: ____________________________________________________________________

APPLICANT’S ADDRESS: _________________________________________________________________

CONTACT NO: ___________________________________________________________________________

2. NAME OF AGENT (IF ANY): _____________________________________________________________

ADDRESS OF AGENT (IF ANY): ___________________________________________________________

CONTACT NO: ___________________________________________________________________________

PTO →
3. ADDRESS FOR CORRESPONDENCE: _____________________________________________________

___________________________________________________________________________________________

4. LOCATION OF PROPOSED DEVELOPMENT: _____________________________________________

___________________________________________________________________________________________

5. DESCRIPTION OF THE PROPOSED DEVELOPMENT:

__________________________________________________________________________________________

__________________________________________________________________________________________

6. IS THIS A PROTECTED STRUCTURE OR WITHIN THE CURTILAGE OF A PROTECTED

STRUCTURE: YES/NO: ______________

IF YES – PLEASE PROVIDE THE RPS REF. NO. ___________________________________________

7. APPLICANT’S INTEREST IN THE SITE: ___________________________________________________

8. LIST OF PLANS, DRAWINGS ETC. SUBMITTED WITH THIS APPLICATION: _______________

___________________________________________________________________________________________

___________________________________________________________________________________________

9. HAVE ANY PREVIOUS EXTENSIONS/STRUCTURES BEEN ERECTED AT THIS LOCATION?

YES/NO: ________________

IF YES – PLEASE PROVIDE FLOOR AREAS OF ALL EXISTING STRUCTURE:

_________________________________________________________________________________________

SIGNATURE OF THE APPLICANT/S (OR AGENT): __________________________________________

DATE: _________________________________________________________________________________________________________

NOTES: REQUIREMENTS FOR A VALID APPLICATION

1. Fee of €80
2. Site Location Map
3. Site Layout Plan
4. Dimensioned Plans & Elevations of the Structures
5. Where the Declaration is in respect of a farm building, a layout plan identifying the use of
each existing building together with the floor area of each building.