ROSCOMMON COUNTY COUNCIL
COMHAIRLE CHONTAE ROS COMAIN
Áras an Chontae, Roscommon, County Roscommon
Tel: 090 66 37100
Email: planning@roscommoncoco.ie
Supplementary Planning Application Form 1
(Rural Housing Applications)
This form is to be completed for sites located within areas designated as Rural Areas Under Urban
Influence and Stronger Rural Areas in Section 6.3 and shown in Map 22 of the County Development
Plan 2008-2014. Please note that a Failure to submit this information will result in delays with the
decision making or lead to a refusal of permission.
Applicant Details
1. Applicant name:
_______________________________________
2. Current Address:
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
3. Principal Occupation: _______________________________________
4. Name and Address of Place of Work: __________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
5.
Do you currently own, or have you ever owned, any residential properties?
YES
NO

If yes, please submit relevant addresses. ___________________
_______________________________________
_______________________________________
_______________________________________
6. Have you ever received a residential planning permission in Co. Roscommon?
YES
NO

If yes, please give details including the planning application reference number.
________________________________
Details of Landholding
7. Does the site form part of a landholding in the ownership of you or a member of your
family?
YES
NO


If yes, please indicate the relationship between the landowner and the
applicant._______________________________________________________
If yes, please also attach Land Registry maps of the entire landholding with the
following clearly marked:
o Location of family home
o Locations of any other family dwellings
o Any other planning permissions on the holdings (including sites that may have
been sold).
Connection to the Local Rural Locality
8. Have you lived in the local area where the site is situated for a substantial period of time?
YES
NO
 If yes, please specify how long you have lived or have been living in the local area and
specify the location. The relevant locations should also be shown on an attached map.
9. Are you a son/daughter of someone living in the area a substantial period of time or
someone who has rural roots to this specific area?
YES
NO
 If yes, how long have they been living in the area and specify the location.
10. Are you personally engaged in Agriculture?
YES
NO
 If yes, what is the nature of the farming/agricultural business being carried out? Please
attach a map of the relevant agricultural holding and documentation in relation to herd
numbers, REPs numbers etc.
11. Are you engaged in a rural based activity or otherwise have some demonstrable need to live
in the local rural area?
YES
NO
 If yes, please attach details.
12. Do you have exceptional health circumstances that require you to live in a particular
environment?
YES
NO
 If yes, please submit relevant documentation from a registered Medical Practitioner and
a disability organisation proving this requirement.
Declaration and Signature
I confirm that the details given in this form (and any attachments) are correct and that if permission
is granted for this dwelling, it will be my principal place of permanent occupation.
Signed: ___________________________________
Date:
___________________________________