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Please only use this form to submit a Regularisation application. On submitting your application you will be able to print an online acknowledgement and upload plans. Fields marked with * are mandatory. GENERAL NOTES CHARGES Note 20 INSULATION Note 23 DRAINAGE     Connection Note 13     Build Over Note 14     Proximity Note 15 HOT WATER STORAGE Note 24 OPENING UP OF UNAUTHORISED WORK Note 21 Applicant Name* Note 1 Address* Postcode* Telephone* Email Note 2 Agent Name Note 3 Address Postcode Telephone Email Location* Note 4 Proposal* Note 5 No Storeys* Proposed Use Note 11 Current Use Estimated Cost Fire Precautions* Yes No Note 6 Date Work Carried Out DD-MM-YYYY This notice is given in relation to the building work as described and is submitted in accordance with regulation 21(3). Please check the box below to show your agreement to this statement and enter your name and the date. Statement* Yes No Note 8 Signature* Note 12 Date* DD-MM-YYYY