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Application Form - To erect a Satellite Antenna Receiver (Dish)
Application Form – To Erect a Satellite Antenna Receiver (Dish)
Download PDF
Leaseholder's name(s)
*
All persons named on the lease must be listed
What type of agreement do you have?
*
Shared Ownership
Right to Buy
Right to Acquire
Address of home where the improvements or alterations are to be carried out
*
Phone number
*
Do you wish to fix a satellite dish to your home?
*
Yes
No
If No, please state the address where it would be fixed.
You will need a signature of consent from the occupier of that home, using the form provided below.
What type of home do you live in?
*
Note: Permission will not be granted if you live in a multi-storey flat
House
Flat
Maisonette
Where on the home do you wish to fix the satellite dish?
*
Note: Permission will not be granted to erect a satellite dish on a roof or chimney stack
Front
Side
Back
Outbuilding
Garden
Satellite Antenna - Declaration
*
I/we declare the information given is a true representation of the improvements or alterations I/we wish to carry out and agree that I/we will adhere to any conditions related to the granting of permission. I/we agree to tell Vico Homes if the information given in the application changes.
Satellite Antenna - Declaration
Leaseholder(s) signature (please type)
*
All persons name on the lease must sign
Name(s)
*
Satellite Antenna - Declaration - To be completed when a satellite antenna will be fixed to a home other than your own
I give my consent for the satellite antenna receiver (dish) to be fixed to my home. I understand that normally only one satellite dish can be fixed to a home and that in the future I may not be able to fix a satellite dish to my own home.
I give my consent for the satellite antenna receiver (dish) to be fixed to my home. I understand that normally only one satellite dish can be fixed to a home and that in the future I may not be able to fix a satellite dish to my own home.
Name(s)
Address
Signature (please type)
Consent for storing submitted data
*
Yes, I give permission to store and process my data
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