The Veolia Environmental Trust Online Application Form

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1 The Velia Envirnmental Trust Online Applicatin Frm Stage 2 questins Please nte: this is nt the Stage 2 applicatin frm 1. Cntact and Organisatin Details a. Main Cntact 1.1 Title 1.2 First Name 1.3 Surname 1.4 Psitin held in rganisatin 1.5 Cntact address 1.6 Cunty 1.7 Pstcde 1.8 address 1.9 Telephne number 2. Alternative number b. Alternative Cntact 1.10 Title 1.11 First name 1.12 Surname 1.13 Psitin held in rganisatin 1.14 Cntact address 1.15 Cunty 1.16 Pstcde address 1.18 Telephne number 1.19 Alternative number c. Organisatin Details 1.16 Organisatin name (this needs t be the full legal name f the rganisatin applying) 1.17 Address Cunty 1.18 Pstcde

2 1.19 Website address 1.20 Are yu a registered Envirnmental Bdy? If Yes, yu will be asked t enter yur ENTRUST number cnfirmatin as t which ENTRUST Categry yur prject has been registered under and t uplad yur ENTRUST 'Prject details' and 'Apprval letter' A pdf cpy f these dcuments wuld have been ed t yu frm ENTRUST fllwing bth the registratin, and the apprval f yur prject 1.21 Select yur rganisatin's legal status (yu will be able t select ne) Cmmunity Grup r Vluntary Organisatin (e.g. Village Hall Management Cmmittee, Friends Of grup, CIO Scuts/Guides) Lcal Authrity (e.g. Parish Cuncil, City Cuncil, Brugh Cuncil) Membership Organisatin (e.g. RSPB, Natinal Trust, Wdland Trust and Wildlife Trusts) Religius Organisatin (e.g. Church, Msque, Temple) Sprting Organisatin (e.g. Sprts Club, CASC, Sprts & Scial Club) Scial Enterprise (e.g. CIC, Industrial and Prvident Sciety, C-Operative) Other Please nte a cpy f yur gverning dcuments may be requested 1.23 Hw and when was yur rganisatin established? (450 characters) 1.24 Are yu a registered charity? If Yes, yu will be asked t enter yur charity number? 1.25 If any, please state the rganisatins wh are a partner t this applicatin, and hw they are invlved (200 characters) 2. Prject Details and Aims a. Prject Details 2.1 Prject title 2.2 Prject site address 2.3 Cunty 2.4 Pstcde 2.5 Prject Aims What type f amenity will this prject maintain, prvide r imprve? 2.6 Prject descriptin (1000 characters) 2.7 Which elements f yur prject are yu asking us t fund? (1000 characters) 2.8 What d yu hpe t achieve by undertaking yur prject? (include hw the prject will make the envirnment mre pleasant r cmfrtable and/r imprve the aesthetic qualities f the area fr the general public) (1,000 characters) 2.9 Wh will benefit frm this prject, and hw will they? (1000 characters)

3 2.10 Uplad yur prject design plan (maximum f 2 designs) 2.11 What cnsideratins have been given t ensure the prject design achieves yur aims? (500 characters) b. Timescale 2.10 Anticipated start date 2.11 Anticipated finish date c. Further Details 2.12 Des yur rganisatin wn the site? Yes N If N, yu will be asked Wh wns this site? and t cnfirm that yur rganisatin has written permissin frm the landwner t undertake this prject and. ur rganisatin hlds a lease fr the site and can prvide a cpy if requested What is the name f the rganisatin that will perate the prject site when the prject is cmpleted? 2.14 I cnfirm that n cmpletin, the rganisatin abve will hld public liability insurance fr the prject site 3. Permissins 3.1 Is planning permissin required befre the prject can begin? N Yes, nt yet apprved Yes, apprved If Yes, nt yet apprved, yu will be asked when yu expect it t be apprved If Yes, apprved, yu will be asked t uplad the planning permissin 3.2 Is religius building cnsent required befre the prject can begin? (e.g. Church Faculty) N Yes, nt yet apprved Yes, apprved If Yes, nt yet apprved, yu will be asked when yu expect it t be apprved If Yes, apprved, yu will be asked t uplad the permissin 3.3 Is Envirnment Agency cnsent required befre the prject can begin? N Yes, nt yet apprved Yes, apprved If Yes, nt yet apprved, yu will be asked when yu expect it t be apprved If Yes, apprved, yu will be asked t uplad the permissin

4 3.4 Are further cnsents required befre this prject can begin? N Yes, nt yet apprved Yes, this has been secured If Yes, nt yet apprved, yu will be asked t detail what is required and when yu expect it t be secured. If Yes, this has been secured, yu will be asked t tell us mre and uplad the permissin 4. Access Details a. Bking and Availability 4.1 Hw many hurs per week will the amenity be available fr cmmunity use? (yu will be able t select ne) 0 15 hurs hurs hurs hurs 4.2 Hw will users bk the amenity? (1000 characters) (cnsider the fllwing: key hlders [if apprpriate] wh will pen the amenity, hw and thrugh whm will the amenity be bked, and charges, if any, t be made fr the use f the amenity) 4.3 Will any grups r individuals be prevented frm using the amenity? (500 characters) b. Cmmunity Use 4.4 Grups that currently use the amenity (1000 characters) 4.5 Wh will use the amenity n cmpletin f the prject? (yu will be able t select ne) Current grups Current and new/ returning users New returning users 4.6 Hw will yu encurage new users including hard t reach grups? (1000 characters) (e.g. Peple with disabilities, lder peple, ethnic minrities, and/r peple nt in educatin, emplyment r training) 4.7 Uplad any evidence in supprt f the abve 4.8 Where and hw will the amenity be advertised? (1000 characters) 4.9 Name f lcal newspaper 4.10 Name f lcal cmmercial radi statin

5 4.11 Cnfirmatin f Access I have cnsulted with the landwner and cnfirm the answers abve will be a true reflectin f the access arrangements fr the amenity and it will be available fr public use and bking fr the freseeable future. Yes N 5. Evidence f Need 5.1 Wh first identified the need fr the prject? (yu will be able t select ne) Our rganisatin Current beneficiaries frm ur lcal cmmunity Ptential beneficiaries frm ur lcal cmmunity The wner f the site Our lcal/reginal cuncil It was as a result f a cnsultatin exercise with ur lcal cmmunity 5.2 What was needed and why? (2000 characters) 5.3 Wh else have yu cnsulted and hw did yu d this? (2000 characters) (include wh yu have cnsulted and hw, the number f peple cnsulted, and the number f respnses e.g. Letterbx drp t 200 lcal residents with 80 respnses, public meeting including current and ptential user grups 65 attended with 15 leaving cmments, thirty lcal schlchildren prvided designs) 5.4 What were the utcmes f the cnsultatin activities? (2000 characters) (this shuld be a summary f the respnses and feedback received, including details f what future users wuld like yur prject t prvide) 5.5 Hw des yur prject meet the identified need? (2000 characters) (include whether yu amended yur prject as a result f yur cnsultatin activities) 5.6 Supprting dcuments (t give yur applicatin the best chance f success please ensure yu have answered the questins abve t the best f yur ability, and uplad additinal dcumentatin t evidence statements made abve (e.g. key letters f supprt received fr the prject fllwing cnsultatin activities) 5.7 Phts f existing prject site (maximum 5 phtgraphs) 6. Prject Benefits a. Vlunteering 6.1 Hw will the prject invlve vlunteers? (yu will be able t select ne) We are unable t use vlunteers in any aspect f ur prject We are an rganisatin run by vlunteers and vlunteers are invlved in fundraising and delivering this prject We are an rganisatin run by vlunteers and vlunteers are invlved in fundraising, r delivering this prject Vlunteers are invlved in fundraising and delivering this prject Vlunteers are invlved in fundraising r delivering this prject

6 6.2 What activities will the vlunteers be invlved in, and what will yur rganisatin and the vlunteers gain as a result? (1000 characters) 6.3 Number f vlunteers expected t help in the delivery f this prject 6.4 Number f yuth vlunteers (aged years) wrking n this prject 6.5 Number f yuth vlunteer days created by this prject 6.6 Will there be an increase in vlunteering pprtunities as a result f this prject? (e.g. On cmpletin f this prject mre peple will be able t vlunteer by prviding additinal services fr the cmmunity) b. Envirnmental Benefits 6.7 Explain what yu have dne t ensure yur prject will benefit the envirnment? (1000 characters) Detail what cnsideratin (if any) yu have given t the pints belw, if yu sught expert advice, what the utcme was, and why this is beneficial. Materials (Are yu using recycled r sustainably surced materials? Are yu able t repair and retain any key features?) Design and Technlgy (Will the prject reduce energy cnsumptin, and have yu incrprated any design features t achieve this? Are 'green' technlgies incrprated int the verall prject?) Design and Nature (Have yu cnsidered hw yur prject will impact lcal wildlife? Have yu included landscaped features in yur design? Are yu creating any additinal habitats t cnserve bidiversity? Hw will yu encurage the cmmunity t psitively interact with nature?) 6.9 If yu have a dcument supprting yur explanatin abve (e.g. an energy audit) uplad it here 7. Prject Finance a. Prject Budget 7.1 Cmplete the table t prvide; a summary f all the items and activities which make up this prject, the ttal cst f each f these (including nn-recverable VAT and payable prfessinal fees), and the funding requested frm us (with the cnsideratin f ur criteria). Yu have a maximum f ten rws, we encurage yu grup similar wrks tgether e.g. electrical, plumbing and drainage wrks. Item/Activity (Quantity/Units) Funding Requested Ttal Cst Ttal (This is autmatically calculated fr yu)

7 b. Funding Requested 7.2 Is the Ttal Funding Requested frm the Trust 40,000 r mre? Yes N If awarded a grant f 40,000 r mre, yu will be required t find an independent Cntributing Third Party (CTP) t make a cntributin f 10% f the grant amunt t ur Landfill Operatr, enabling the release f the grant frm the Trust. The CTP cntributin shuld nt be cnsidered as Funding Frm Other Surces fr yur prject. This is an additinal cntributin which is required within fur mnths f yur grant being awarded. We will nly ask yu wh yur CTP is ging t be if yu are awarded a grant f 40,000 r mre, and we will prvide yu with all the infrmatin yu and yur CTP require at that time. 7.3 Have yu read the statement abve, and understand that a 10% cntributin is required t release grants f 40,000 r mre? Yes N Funding Frm Other Surces 7.4 Cmplete the table t shw a breakdwn f all funding yu have secured, and hpe t secure t cmplete yur prject (d nt include yur request t us) Funding Organisatin/Surce Amunt Status Decisin Date 7.5 Hw much funding have yu secured s far twards this prject? 7.6 Uplad evidence f yur secured funding belw (e.g. grant award letter) c. Value Fr Mney 7.7 Hw are yu ensuring that best quality and value fr mney will be achieved when undertaking this prject? (Describe the evaluatin prcess yu have r will cmplete t select yur preferred cntractr) (500 characters) 7.8 Uplad yur dcument(s) which supprt the prcess described abve (if available) 7.9 What is the average amunt f incme per year yu expect t generate as a result f this prject? (This shuld ONLY be additinal r new incme as a direct result f undertaking this specific prject. Yu may wish t cnsider the fllwing pints: Estimated increase in user numbers fllwing cmpletin f the prject The average amunt each user will pay t visit/use the amenity Any ther surces f incme generated as a result f this prject)

8 7.10 Cnfirm any incme generated will be ring-fenced fr the nging running and maintenance f the amenity Yes, I cnfirm N 7.11 Hw will the amenity be maintained? 7.12 What is the prjected lifespan f the amenity? (in years) 8. Declaratin Cnfirm yu agree t each f the fllwing declaratins listed belw Any breach f these declaratins culd result in the recvery f any mnies awarded. If yu are unable t cnfirm any f the fllwing pints, select N I cannt cnfirm the abve, and explain the reasn. I cnfirm that the amenity will nt be perated fr prfit. I cnfirm that any incme earned by this prject will either be reinvested in the running f the prject r returned t the Envirnmental Bdy (EB) as LCF-derived funding. I cnfirm that any assets r prprtin f assets purchased with LCF mnies will be prtected t ensure that n future actins result in LCF mnies being lst frm the Fund. I cnfirm that any Cntributing Third Party fr this prject will neither make a cntributin which is derived frm LCF mnies nr receive a unique benefit frm any frm any prject run by the EB. I cnfirm that there will be n unique benefit t any Landfill Operatr wh has made a cntributin t the EB. I cnfirm this prject registratin is t cver wrk n a single specific amenity. I can cnfirm that the prject is nt a cnditin f any planning permissin r any statutry cnsent arising frm an applicatin f a cntributing Landfill Operatr. I can cnfirm that the prject is nt a term f an agreement, t which the Landfill Operatr is a party, made under: - Sectin 106 f the Twn and Cuntry Planning Act 1990; - Sectin 75 f the Twn and Cuntry Planning (Sctland) Act 1997; r - Article 40 f the Planning (Nrthern Ireland) Order I cnfirm that the LCF funded part f this prject will nt invlve spending LCF mnies n areas that are nt accessible by the public e.g. charity headquarters, administratin ffices etc. Organisatin Applicant cnfirmed by

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