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Local listing nomination form
Local listing nomination form
Last Modified June 14, 2017
Download as PDF
pdf
Building and location
Full address (including postcode) of nominated building
Owner of building (if known)
Type of building
eg. Bank, Dwelling house
Please describe current use, if changed from historic use
If vacant, please describe current condition
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Building history
Approximate date of construction
Brief history of the building
You must provide photographs to support the application
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Reasons for nomination
Please provide details of why you think this building should be included in the local list.
Please review the inclusion criteria
Sources
Eg. Blackpool Gazette and Herald (with date), OS maps, trade directories
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Details of person nominating
Name
First
Last
Anonymous nominations will not be accepted
Address
Email
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Submit
Additional information
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