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Crouch Harbour Authority Works Licence Application Form
Application for a Works Licence under the Crouch Harbour Act 1974
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* Indicates required question
Applicant
Name
*
Your answer
Business Name (if applicable)
Your answer
Address
*
Your answer
Postcode
*
Your answer
Phone
*
Your answer
Email
*
Your answer
Details of Works
Address of Site to which application relates
*
Your answer
Postcode
*
Your answer
Brief description of proposed works
*
Your answer
Proposed methods of construction or works
*
Include details of materials to be utilised or methods of dredging and spoil disposal
Your answer
Does the proposed work involve a new or altered access to the Harbour Area
*
Yes
No
If yes please specify
Your answer
Does the proposed work involve or affect any existing works or structures
*
Yes
No
If yes please specify
Your answer
Do the works affect any existing seawall or tidal defence
*
Yes
No
If yes please specify
Your answer
Declaration
*
I/We apply for a Crouch Harbour Authority Works Licence to carry out the works described in this application and certify that all information set out in the application is correct. In the event that false information is provided in relation to this application it will be a condition of any Works Licence issued pursuant to this application that the Licence shall be void and that any works completed subsequent to the issuing of the Licence shall be removed forthwith.
I agree to the Declaration and Works Licence Terms and Conditions
Required
Signed
*
Your answer
On behalf of
Your answer
Date
*
MM
/
DD
/
YYYY
Accompanying Documents
Please send the plans and documents as set out in our Terms and Conditions to info@crouchharbour.org.uk.
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