HMA Strategic Housing Land Availability Assessment - Site Suggestion Form for Sites in Amber Valley

If you wish to promote a site for inclusion in the assessment, please fill in the form below as fully as you can. Forms should be completed by 12 September 2008.

Forms should be returned to Carol-Anne Taylor, Principal Planning Officer, Regeneration and Sustainability, Amber Valley Borough Council, PO Box 18, Town Hall, Ripley, Derbyshire DE5 3SZ by 12 September 2008

PLEASE NOTE THAT YOUR SUGGESTED SITE WILL NOT BE CONSIDERED IF YOU DO NOT INCLUDE WITH THIS SUBMISSION A LINK TO A LOCATION MAP SHOWING CLEARLY ITS BOUNDARY WITH STREET/ROAD NAMES

Your Details
Your Title
Your first name
Your last name
Your email address
Telephone Number
Your address	If the property is in the Amber Valley area please enter your postcode or the first few letters of your street and click on the next button to lookup your property. Otherwise enter your full address in the box below.
Your organisation/business (Optional)
Role:
Site Details
Site Address	If the property is in the Amber Valley area please enter your postcode or the first few letters of your street and click on the next button to lookup your property. Otherwise enter your full address in the box below.
Site Area (Ha)
Current Use / Description:
Relevant Planning History:
Access to Services & Transport Network (provide details of nearest)
Is the site awaiting relocation of an existing use?:
Level of Developer Interest:
Are there any sustainability issues or physical constraints that you know of which might effect the suitability for development?
Environmental Constraints (e.g. contamination)
Other Conservation Designations (e.g. Conservation Area)
Physical Constraints (e.g. Topography, TPO's)
Planning Policy Constraints (e.g. Green Belt)
Utilities Constraints:
Access Constraints:
Economic Constraints:
Ownership Constraints:
Other Constraints:
If so, could interventions to be made to overcome the constraints?:
Number of dwellings/timescales
What is the estimated number of dwellings that could be provided on the site, taking into account the type of development likely to be suitable, affordable housing requirements, height and character of surrounding buildings, density requirements etc?:
When is the site likely to be developed?:
Site Coordinates
Include your map by uploading a pdf document clearly showing the site boundary OR:
Draw the site outline on our on-line mapping. Clicking the button will display a map on which you can draw the site boundary.
For further information on the Assessment Tel. 01773 841583 or email carolannet@ambervalley.gov.uk