APPLICATION FOR COUNCIL CONSENT

[NON SITING MATTERS]

BUILDING REGULATIONS 2006

TO:MunicipalBuilding Surveyor
City of Greater Geelong / Office Use Only
P O Box 104, Geelong 3220 / Class / Type / Year / Number
Ph: (03) 5272 4450 Fax: (03) 5272 4486 / BG / CCG / 201….
Prop No.

Re:No. ……. Street/Road …………………………………………………………………………………………

Suburb: …………………………………………………..……………………………Post Code: …………

Proposed Design Description: ………………………………………….…………………………………...………

………………………………………………………………………………………………………………………………

I, ………………………………...... …..…. RelevantBuilding Surveyor, Owner, Agent of Owner (circle)

Postal Address: …………………………………..……………………………………………………………………..

Email: ……..……………………..….….……………Post Code:…….…….Telephone: ……………..…...………

hereby give a copy of a building design/building permit application to Council for consent or report in accordance with Schedule 4 (Part 2) of the Building Regulations 2006:

Tick / Regulation / Matter to be Reported on / Minimum Fee
513(1) / Projections beyond street alignment / $244.00
515(2) / Building above or below certain public facilities / $244.00
604(4) / Precautions over a street
(also accompanied by Street Occupation/Parking Permit Application) / $244.00
802(3) / Construction of buildings on land liable to flooding / $244.00
802(3) / Construction of buildings on land liable to flooding at other than minimum height above flood level / $244.00
806(1) / Building on designated land / $244.00

Please provide the following information:

Fee [listed above]

Up-to-date, clear copy of Certificate of Title

Clear and complete design or building permit applicationdocuments (2 copies please)

Note: / 1 / A Fee of $244.00[allows for a maximum 1 hour assessment] must be paid when making application
2 / Council is collecting this information in accordance with Schedule 4 (Part 2) of the Building Regulations 2006. The personal information will be used solely by Council for the purpose of processing an Application for Council Consent. You may access the information by contacting Council on 5272 4486. If you fail to provide this information your application may not be processed.
3 / Where requesting a level lower than the specified floor level, note the following:
a)
b) / a drainage system designed and certified by a Registered Engineer that includes all necessary site and floor levels to AHD that would provide adequate immunity to the building from the effect of flooding,and also complies with AS/NZS 3500, may need to be provided; and
The Owner may be required to enter into a Section 173 Agreement with Council.

Signed:………………………………………………………..…….. Date: …………….…………………

Council will endeavour to report on the above as soon as possible, however it is possible that the time limits of the Building Regulations 2006 will not be met. Please consult with Council’s Building Control Services as to time frames at referral.

OFFICE USE ONLY

Regulation / Referral To: / Date Sent / Date Returned: / Comment
513(1) / Dial before you dig 1100
515(2) / Traffic Engineer
Local Laws
801.1 / Health Department
802(3) / Flooding Engineer
806(1) / Flooding Engineer
Site Inspection By: / Date: / Time:
Comments:
Conditions:
Invoice Raised 
Recommendation:
 Application Be Approved
 Application Be Approved with Conditions
 Application Be Refused
Signed: / Date:
Council Delegates Decision:
 Permission Granted
 Refused
Signed: / Date:

ABSSSF-014\BELMONT\BUILDING\STATUTORY STD FORMSLAST SAVED DECEMBER 2014

CREDIT CARD AUTHORITY

ABSSF-014\BELMONT\BUILDING\STATUTORY STD FORMSLAST SAVED DECEMBER 2014

This form must be completely filled out and signed

DATE: / / / 20

 VISA MASTERCARD

CREDIT CARD NUMBER:

PAYMENT AMOUNT:
Inclusive of GST / $ / EXPIRY DATE: / /
NAME OF CARD HOLDER:
CARD HOLDER SIGNATURE:
REASON FOR PAYMENT
What are you applying for?
PROPERTY ADDRESS:
Please forward this form to: / E-mail:
Mail:Building Services, PO Box 104 Geelong VIC 3220
In person: Any City of Greater Geelong Customer Service Centre or the Building Dept. at 100 Brougham Street, Geelong

As of the 14th October a processing fee of 0.4% will be added to the total payment amount, when using the credit card option including MasterCard or Visa.

PLSL-025