Application Form LIS - Donegal County Council

advertisement

DONEGAL COUNTY COUNCIL

LOCAL IMPROVEMENT SCHEME - APPLICATION FORM

(Roads & Transportation Section, County House, Lifford, County Donegal)

Tel: 074-9172222 Fax: 074-9141205

Application No.:__________________

FOR OFFICE USE ONLY.

1.

We the undersigned each being the occupier of agricultural land in the townland(s) referred to at (5) overleaf, hereby apply to the Donegal County Council for a grant towards the cost of the work described in (5) – (8) overleaf and if the grant is made available we apply to have the said work carried out by Donegal County Council as

Agent for each of us. We and each of us hereby agree to be bound in all respects by each and every one of the terms and conditions of the Scheme.

2.

We hereby appoint and delegate full power to Mr/ Mrs/Miss/Ms

_________________________ of ___________________________________________ to act for us in all correspondence and other business arising out of this application and we each of us agree to be bound by such correspondence and by all acts of the said

Mr/ Mrs/Miss/Ms _____________________Tel. No./Mob. No. ___________________

3.

LIST (1) BENEFICIARIES OF SCHEME:

NAME (BLOCK CAPS) SIGNATURE POSTAL ADDRESS

________________________ _______________________ ____________________

________________________ _______________________ ____________________

________________________ _______________________ ____________________

________________________ _______________________ ____________________

________________________ _______________________ ____________________

Further signatures may be written on an additional sheet if necessary.

4.

I certify that List 1 above (and additional sheet if necessary) contains the names of all landowners and others whose land, houses or other property would be served by this scheme as verified by me. I also certify that I have read and completed the Check List on page 4 attached.

Signature of Applicant’s Representative/Promoter __________________________________

Date: _____________________________________________________________________

(Nominated at paragraph (2) above)

Postal Address_______________________________________________________________

Page 1 of 4

LOCATION/DESCRIPTION OF WORKS :

N.B. This application will only be considered if accompanied by an Ordnance Survey Map/Area Aid

Map indicating the location and extent of the project with beneficiaries lands clearly marked. Map should also indicate where proposed work joins the public road.

5. ELECTORAL AREA ________________ TOWNLAND __________________________

6.

LENGTH OF ROAD TO BE IMPROVED(mark on map) _______________________________

7.

WIDTH OF ROAD TO BE IMPROVED _____________________________________________

8.

DESCRIBE WORKS REQUIRED (eg DRAINAGE, TARRING, GULLIES, ETC. )

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

9.

ARE APPLICANTS INTENDING TO CARRY OUT PREPARATORY WORKS SUCH AS HEDGE

CUTTING, CLEANING VERGES OR STRENGTHEN SOFT SPOTS. _____YES/NO____________

IF YES, GIVE DETAILS:

___________________________________________________________________________________

___________________________________________________________________________________

EVIDENCE OF MEETING ELIGIBILITY CRITERIA :

10.

DOES THE PROPOSAL SERVE ANY OUTSIDE FAMILIES OR THE PUBLIC GENERALLY

AND IF SO FOR WHAT PURPOSE ?

_______________________________________________________________________

_______________________________________________________________________

10. ARE ALL PERSONS WHOSE INTERESTS OR WHOSE LANDS WOULD BE AFFECTED IN

ANY WAY BY THE PROPOSAL, IF CARRIED OUT, PREPARED TO GIVE THE NECESSARY

CONSENT TO THE EXECUTION OF THE WORK?

_______________________________________________________________________

11. For applicants currently involved in farming, please quote below Herd No./Flock No. and attach recent * original correspondence from Dept of Agriculture bearing name/address of applicant. ( * within six months)

Name: Herd no./Flock no: Letter Attached:

______________________ ________________________ ___YES/NO___

______________________ ________________________ ___YES/NO___

______________________ ________________________ ___YES/NO___

______________________ ________________________ ___YES/NO___

Page 2 of 4

12. For applicants currently involved in farming who do not have a Herd No./Flock No., please give the following information:-

Name: * No. of Type of Farming: No./type animals:

Acres

__________________ ___________ ______________ _____________

__________________ __________ ______________ _____________

* NOTE – Project proposed must benefit the land being farmed.

13. NAMES OF ALL PERSONS WHOSE INTERESTS OR LAND WOULD BENEFIT BY THE

PROPOSED WORK BUT WHO HAVE NOT JOINED IN THIS APPLICATION

NAME (BLOCK CAPS) SIGNATURE POSTAL ADDRESS

_____________________

_____________________

_________________ _____________________

_________________ _____________________

_____________________ _________________ _____________________

_____________________ _________________ _____________________

If there are no beneficiaries other than those who have signed at List 1 the word “none” should be written above.

14. HAS THE PROPOSED WORKS EVER BEEN MAINTAINED OR REPAIRED BY THE COUNCIL

IN THE PAST. __________YES/NO___________

IF YES, GIVE DETAILS:

_________________________________________________________________________________

_________________________________________________________________________________

Completed applications should be sent to:

Roads & Transportation Office

Donegal County Council

County House

Lifford

County Donegal

PLEAE NOTE: The closing date for applications under the Local Improvement

Scheme each year is 31 st October for schemes to be processed in the following year.

Page 3 of 4

LOCAL IMPROVEMENT SCHEME APPLIES TO NON-PUBLIC

ACCOMMODATION ROADS (FARM ROADS AND CERTAIN ROADS

SERVING THE PUBLIC*) AND BOG ROADS

*This refers to a road of the kind which although not a public road may connect two public roads or give access to beach or commonage and so serves the local agricultural community.

CHECK LIST:

(1)

Please Circle if understood & accepted.

Is map attached indicating location, extent and beneficiaries of proposed work as per Page 2: YES / NO

(2)

(3)

Are Sections 10 – 14 fully completed showing evidence of meeting eligibility criteria? YES / NO

(4)

We understand that the following types of schemes will not qualify:

Schemes serving only one landholding

Schemes that do not support agriculture, beach access or turbary or the public generally

Minor works of a maintenance nature

Small schemes because of their size would be uneconomical for the Council to carry out

Drainage only Schemes YES/NO

The promoter agrees to:-

Collect the agreed amount of local contribution and lodge with Donegal County Council YES/NO

Arrange for the provision, without cost to Donegal County Council, of any lands required as part of the Scheme for road widening etc YES/NO

(5) In general, in relation to the scheme, the following is understood:-

Specification, materials and standard of works shall be a matter for Donegal County Council.

In the event of unforeseen ground conditions/obstructions, Donegal County Council will only expend the amount of grant allocated and shall not be liable for completion of the original scheme in such circumstances

*

.

Applicants shall be responsible for future maintenance of completed scheme YES/NO

No person, whether a contributor or not, whose interests are affected will impede the execution of the work by making unreasonable demands on the Council officials

The contributors and any other persons whose lands or interest appear to be affected by the proposed work must, when required, prior to the commencement of the work, sign the prescribed form giving their full consent to the execution of the work including entry into their land, etc.

*

In such circumstances, applicants may apply for a supplementary scheme to complete the works.

SIGNED: ______________________________________ ________________________________________

PROMOTER OF SCHEME DATE

Page 4 of 4

Download