Marine and Coastal Access (MCA) Act 2009 Marine Licence Application Form Activities that may require a marine licence, because they cannot be controlled under the Petroleum Act 1998 (as amended) or Energy Act 2008, or are not exempted under the Marine Licensing (Exempted Activities) Order 2011 (as amended), will include (but may not be limited to): Disturbance of the sea bed, e.g. to access platform legs or to relocate cuttings piles, or to undertake trenching operations that are not covered by a Pipelines Works Authorisation (PWA) issued under the Petroleum Act. Temporary deposits, e.g. during abandonment operations or in advance of activities authorised under the Petroleum Act or Energy Act. Deposit or removal of certain cables, e.g. telecommunications, power or control cables not covered by a PWA. Deposits or removal of substances or objects, e.g. to undertake rock dumping, mattress emplacement or burial operations that are not covered by a PWA, or to remove platforms or other infrastructure from the sea bed. Deposit and use of explosives, e.g. to remove seabed obstructions, to sever wellheads or during the course of other decommissioning activities (N.B. seismic use of explosives would be covered by the DECC geological survey consenting regime). Guidance in relation to the DECC MCA Act licensing regime can be found on the DECC Oil and Gas website at www.og.decc.co.uk\XXXX , or by contacting the DECC Environmental Management Team (emt@decc.gsi.gov.uk or 01224 254045 / 254050 Applications for a marine licence will require the payment of a fixed sum application fee. You will be invoiced for the fee following submission of the application. In the case of applications supported by an Environmental Statement (ES), there will be a separate fee to cover the costs associated with the ES review process, which will be calculated based on the time spent dealing with individual submissions. You will therefore be invoiced separately for this fee, following completion of the review process. Further information in relation to the DECC MCA Act marine licence charging scheme, and the Marine Works (Environmental Impact Assessment) Regulations 2007 (as amended) charging scheme, can be found on the DECC Oil and Gas website at www.og.decc.co.uk\XXXX . Marine Licence Application Form Department of Energy and Climate Change, Atholl House, 86-88 Guild Street, Aberdeen AB11 6AR 1 All tables and text boxes in this application form can be expanded as necessary. 1. TYPE OF APPLICATION a) Is this an application for a new marine licence? YES/NO b) Is this an application to amend an existing marine licence? YES/NO c) Is this an application to extend an existing marine licence? YES/NO d) Is this an application to renew an existing marine licence? YES/NO The period of validity of marine licences can be extended up to a maximum of one year (12 months), but licences must be renewed if activities will extend into a second year. If you are applying to amend, extend or renew an existing licence, any changes in the application form must be clearly highlighted. 2. APPLICANT DETAILS To be completed for all applications. Name of Company Address Name of Contact Position within Company Telephone Number Fax Number E-mail NOTE: The applicant will normally be the licensed operator. 3. LICENSED OPERATOR DETAILS To be completed for all applications. If the Licensed Operator is the Applicant, please tick this box and move to Section 4. Name of Company Address Name of Contact Position within Company Telephone Number Fax Number E-mail Marine Licence Application Form Department of Energy and Climate Change, Atholl House, 86-88 Guild Street, Aberdeen AB11 6AR 2 4. ACTIVITY DETAILS To be completed for all applications. Location of Proposed Works: Latitude / Longitude Coordinates: Quad/Block: XXo XX’ XX North (degrees, minute and seconds) XXXo XX’ XX East*/West* (* delete as appropriate) Field Name: Earliest Start Date: End Date: Description of Proposed Activity Please provide details of the proposed activity in the following text box, or enter the name of any relevant document or file submitted in support of the application. NOTE: For applications relating to a number of licensable activities, please clearly identify the separate activities. Marine Licence Application Form Department of Energy and Climate Change, Atholl House, 86-88 Guild Street, Aberdeen AB11 6AR 3 5. ENVIRONMENTAL IMPACT ASSESSMENT Is the application supported by an Environmental Statement? YES/NO If “Yes”, a copy should be submitted to accompany the application form. If “No", please provide an environmental impact assessment in the following text box, or enter the name of any relevant document or file submitted in support of the application. Marine Licence Application Form Department of Energy and Climate Change, Atholl House, 86-88 Guild Street, Aberdeen AB11 6AR 4 6. SUMMARY ENVIRONMENTAL INFORMATION a) Are there any protected sites (e.g. SPA / SAC / RAMSAR / SSSI), or candidate protected sites within 40 km of the activity? YES/NO If “Yes”, please list them below. Site b) Designating feature(s) Distance from activity (km) Is the activity within a fish or shellfish spawning or nursery area? YES/NO If “Yes”, please provide details of relevant species and relevant times of the year? Species Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec S = Spawning, N = Nursery, J = Juveniles, NS = No documented sensitivity, Blank = No data (more than one code can be entered) c) Are there times of the year when seabirds in the vicinity of the activity are more vulnerable than at other times of the year? YES/NO Please provide details of seabird vulnerability. Quadrant/ Block Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 = Very High, 2 = High, 3 = Moderate, 4 = Low, Blank = No data d) Are there times of the year when sea mammals (e.g. dolphins porpoises, whales, seals etc) in the vicinity of the activity are more abundant than at other times of the year? YES/NO Please provide details of sea mammal abundance. Species Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 = High Density, 2 = Moderate Density, 3 = Low Density, Blank = No data e) Are there any other outstanding or unusual environmental features in the vicinity of the activity (e.g. seasonal algal blooms, sessile benthic species and geological or archaeological features)? YES/NO Marine Licence Application Form Department of Energy and Climate Change, Atholl House, 86-88 Guild Street, Aberdeen AB11 6AR 5 If “Yes”, please provide details in the following text box, or enter the name of any relevant document or file submitted in support of the application. f) Please provide details of the sources on the summary environmental information. Protected sites Fish / shellfish Seabirds Marine mammals Other environmental features 7. CONSULTATION Has there been prior consultation with any relevant stakeholders, e.g. the MMO, Devolved Authorities, Statutory Nature Conservation Agencies, MCA, Statutory Light Authorities or MOD? YES/NO If “Yes”, please confirm which bodies have been consulted, whether there were any objections, and whether copies of any relevant correspondence have been provided to accompany the application. Name of Body 8. Did they object to the activities? (YES/NO) Is relevant correspondence provided? (YES/NO) MARINE LICENCE VARIATIONS If you are applying to amend, extend or renew an existing marine licence, please provide a chronological summary of all requested variations. Marine Licence Application Form Department of Energy and Climate Change, Atholl House, 86-88 Guild Street, Aberdeen AB11 6AR 6 9. COMPLETED APPLICATIONS Completed applications should be forwarded to the DECC Environmental Management Team, preferably by e-mail to emt@decc.gsi.gov.uk or by post to: Department of Energy and Climate Change (DECC) Energy Development Unit (EDU) Offshore Environment and Decommissioning Branch (OED) Environmental Management Team Atholl House 86-88 Guild Street Aberdeen AB11 6AR All routine applications should be submitted at least 28 days in advance of the proposed commencement of the licensable activities, and applications supported by an Environmental Statement should be submitted at least three months in advance of the proposed commencement of the activities. If any information is not available at the time of submission, this should be indicated in the appropriate section of the application form, and the information should be provided separately as soon as possible. Any delay in forwarding information or responding to DECC enquiries is likely to result in a delay in determining the application. Marine Licence Application Form Department of Energy and Climate Change, Atholl House, 86-88 Guild Street, Aberdeen AB11 6AR 7