FORM
CUSTOMISED MAP APPLICATION
Please return to , PO Box 366, Ingham Q 4850 or Fax (07) 47763233
APPLICANT DETAILSDELIVERY METHOD / Name: ______
£ Email / Postal Address: ______
£ Post / Email Address: ______
£ Pick Up / Contact Phone Number: ______Fax:______
£ Fax / Signature of Applicant: ______
PROPERTY LOCATION / LOT & PLAN / EXTRA INFORMATION
AVAILABLE DATASETS Please indicate the number of maps and the size required.
☐ Zoning – Scheme maps available on web ☐ Historical Flood Heights – (Data from 1967 onwards)
☐ Aerials Photography (October 2015) ☐ Contours (0.25cm)
Flood Hazard and Depth Data:
☐ PMF Depth ☐ PMF Hazard ☐ 500 Yr Depth ☐ 500 Yr Hazard ☐ 100 Yr Depth ☐ 100 Yr Hazard
☐ 50 Yr Depth ☐ 50 Yr Hazard ☐ 20 Yr Depth ☐ 20 Yr Hazard ☐ 10 Yr Depth ☐ 10 Yr Hazard
☐ 5 Yr Depth ☐ 5 Yr Hazard Note: Only one option per map. Multiple fees apply.
Mapping available online for township areas: https://www.hinchinbrook.qld.gov.au/economic-development-tourism-planning/online-mapping-h4ztm6/mapping-and-gis-services/
£ A4 $13.00 / £ A3 $19.00 / £ A2 $24.00 / £ A1 $37.00 / £ A0 $49.00
Total number of Maps ______Total $______
OFFICE USE ONLY Receipt Code 139CASHIER: / RECEIPT NO: / AMOUNT: / DATE:
GIS OFFICER: / DATE:
The request will not be processed until the prescribed fee has been paid. A five (5) full working day completion time applies after the date of lodgement by post, fax or email. Payment can be made in person or by post. Credit card payments are also accepted. Contact Council on 4776 4600 for payment or fill out the following details.
CREDIT CARD DETAILS: MASTERCARD VISA
NAME ON CARD: ......
CARD NUMBER: ......
EXPIRY DATE: ......
Electronic version current. Uncontrolled Copy current only at time of printing
Form Number: ISD-EF-005 Version No: 7
Authorised By: Assets and Infrastructure Current Version Date: 30 October 2017
Document Maintained By: GIS Technical Officer Implementation Date: 1st July 2010
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