Resource Management (Forms, Fees, and Procedure) Regulations 2003
Schedule 1
Form 9
Application for resource consent[1]
Sections 88 and 145, Resource Management Act 1991
To [The Minister of Conservation or the Environmental Protection Authority]
I, [full name], apply for the following type(s) of coastal permit:
[Note: A consent to do something in a coastal marine area that otherwise would contravene any of sections 12, 14, 15, 15A, and 15B in this Act is called a coastal permit]
[Describe the activity to which the application relates].
The location of the proposed activity is as follows:
[describe the location as it is commonly known and in a way that will enable it to be easily identified (e . g . the legal description, the name of any relevant stream, river, or other water body to which the application relates, proximity to any well-known landmark, the grid reference (if known))].
No additional resource consents are needed for the proposed activity (or The following additional resource consents under the Resource Management Act 1991are needed for the proposed activity and have (or have not) been applied for: [give details]).
I attach, in accordance with Schedule 4 of the Resource Management Act 1991, an assessment of environmental effects in the detail that corresponds with the scale and significance of the effects that the proposed activity may have on the environment.
I attach any information required to be included in this application by the regional plan, the Resource Management Act 1991, or any regulations made under that Act.
[List all documents that you are attaching.]
*As this is an application for a coastal permit for reclamation, I attach information to show the area proposed to be reclaimed, including its location, the position of all new boundaries, and the proportion of that area (if any) to be set apart as an esplanade reserve or esplanade strip.
*Delete if this is not an application for a coastal permit for reclamation.
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Signature of applicant (or person authorised to sign on behalf of applicant)
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Date:
Address for service of applicant:
Telephone:
Fax/email:
Contact person: [name and designation, if applicable]
Note to applicant
You may apply for 2 or more resource consents that are needed for the same activity on the same form. If the application is lodged with the Environmental Protection Authority, you must also lodge a form in form 16A at the same time. You must pay the charge payable to the consent authority for the coastal permit application under the Resource Management Act 1991 (if any). If your application is to the Environmental Protection Authority, you may be required to pay actual and reasonable costs incurred in dealing with this matter (see section 149ZD of the Resource Management Act 1991).
Resource Management
Resource Management Act 1991
Schedule 4
1 Matters that should be included in an assessment of effects on the environment
Subject to the provisions of any policy statement or plan, an assessment of effects on the environment for the purposes of section [88] should include—
(a) A description of the proposal:
(b) Where it is likely that an activity will result in any significant adverse effect on the environment, a description of any possible alternative locations or methods for undertaking the activity:
(c) Repealed.
(d) An assessment of the actual or potential effect on the environment of the proposed activity:
(e) Where the activity includes the use of hazardous substances and installations, an assessment of any risks to the environment which are likely to arise from such use:
(f) Where the activity includes the discharge of any contaminant, a description of—
(i) The nature of the discharge and the sensitivity of the proposed receiving environment to adverse effects; and
(ii) Any possible alternative methods of discharge, including discharge into any other receiving environment:
(g) A description of the mitigation measures (safeguards and contingency plans where relevant) to be undertaken to help prevent or reduce the actual or potential effect:
[(h) identification of the persons affected by the proposal, the consultation undertaken, if any, and any response to the views of any person consulted:]
(i) Where the scale or significance of the activity's effect are such that monitoring is required, a description of how, once the proposal is approved, effects will be monitored and by whom.
Please Note:
(1) Section 107 of the Resource Management Act prevents the Minister of Conservation from granting a coastal permit to discharge a contaminant
If, after reasonable mixing, the contaminant of water discharged (either by itself or in combination with the same, similar, or other contaminants or water) is likely to give rise to all or any of the following effects in the receiving waters.
(i) The production of any conspicuous oil or grease films, scums or foams, or floatable or suspended materials:
(ii) Any conspicuous change in the colour or visual clarity:
(iii) Any emission of objectionable odour:
(iv) The rendering of fresh water unsuitable for consumption by farm animals:
(v) Any significant adverse effects on aquatic life.
(2) In the explanation to assist in preparing the AEE, the receiving environment (= waters of the Marine Reserve) should be described as the water of the Marine Reserve at locations X, Y, Z.
[1] Resource Management (Forms, Fees, and Procedure) Regulations 2003
Schedule 1 Form 9 - Reprinted as at 1 November 2010 and modified for the purposes of the Regional Coastal Plan: Kermadec and Subantarctic Islands.