St Helens Locally Listed Heritage Assets Nomination Form

Details of the individual / group Nominating a building or structure of Local Importance
1. Name
2. Address
3. Telephone
4. Email
5. If we require any further information, please specify your preference as to how we should contact you. (optional)
  
  By Post
  
  By Telephone
  
  By Email
Details of the Building/Structure of Local Importance
1. Name
2. Address
3. Date of construction (if known)
4. Owner (if known)
5. Parish / Ward
6. Grid Reference (if known). (optional)
7. Within a Conservation Area
  
  Yes
  
  No
  
  Unknown
Type of Building/Structure
1. Is the building/structure one of the following? Please tick one option.
  
  A building or group of buildings (e.g. dwellings, public buildings, commercial/industrial buildings, places of worship, agricultural buildings)
  
  A monument, sculpture, statue or public art
  
  A place (e.g. a street, park, recreation ground, garden or natural space)
  
  An archaeological site (buried archaeological remains and upstanding remains or earthworks)
  
  Street furniture (e.g. bollards, street lighting, lampposts, milestones, signposts, railings, drinking foundations)
  
  Other (please specify below)
2. Other (please specify) (optional)
Reason for nomination
1. Please indicate which of the following selection criteria you consider the building or structure of local importance to meet:
  
  Architectural or Artistic Interest
  
  Historic Interest
  
  Archaeological Interest
  
  Authenticity (age, rarity, intactness)
  
  Social and Communal Interest
  
  Group Value
  
  Townscape/Landscape Interest (including landmarks)
Supporting information
1. Please provide a brief statement of the significance or special interest of the building or structure of local important within the local context:
Further information
1. Please use this space to provide any further information you consider relevant to the nomination.
Freedom of Information Act 2000
As a public authority under the Freedom of Information Act 2000, St Helens Borough Council may be asked to disclose your details in response to a request. We will contact you for your views first should this occur.

Data Protection
We process personal data as part of our public task to create planning policy in the borough and will retain this in line with our Information and Records Management Policy. For more information on what we do and on your rights, please read our GDPR statement on the development plans privacy notice page and the council's general data protection advice on our data protection and Freedom of Information page.

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St Helens Locally Listed Heritage Assets Nomination Form