Form – B

Intention to proceed to a Development Agreement – Works

Form ‘B’ is to be lodged with South East Waterif the formal Development Agreement is unable to be executed by all parties within 3 months from the issuing date to avoid lapsing.

The lodgment of Form ‘B’ does not waive the requirement for the Development Agreementto be formally executed by allparties within 6 months from the issue date. If execution does not occur within 6 months a new application will be required.

Note: Should New Customer Contributions be paid more than 3 months from the Development Agreement issue date, New Customer Contributions will be calculated at the current rates at the time of payment.

Important:Do not commence construction works prior to the formal Development Agreement being fully executed by all relevant parties.

To:South East Water, PO Box 2268 Seaford VIC 3198

Telephone: 131 694DX 36006

1.Details of Development

Estate:
Address:
Postcode:
South East Water Ref: / File number: / Case number:
Development Agreement issue date:

2.Details of Developer (Owner)

Developer:
Contact Address:
Postcode:
Email: / Phone:
Owner’s Signature:
Print Name: / ...... Date:

3.Name of Consultant

Important Privacy Notice

South East Water Corporation ABN 89 066 902 547 (SEWC) is a Statutory Corporation created as a Water Authority under the Water Act, which provides retail water, recycled water, sewerage and trade waste services to Melbourne’s South Eastern suburbs.

By completing this form you are providing personal information to SEWC for the primary purpose of SEWC providing you with water, recycled water and/or sewerage supply.

Additionally, SEWC may share your personal information with service providers and other external organisations in limited circumstances, such as to:

  • government or regulatory authorities;
  • mail houses and other companies for the purposes of distributing statements of account and handling mail; and
  • information technology companies for the purposes of maintaining information technology and security systems.

If you do not provide the information requested by this form, then we may not be able to process your application for the provision of water supply, recycled water or sewerage facilities.

You may request access to your personal information which SEWC holds about you. You can make such a request by writing to the Privacy Officer at

PO Box 2268 Seaford VIC 3198. Additionally, South East Water’s Privacy Policy is available on the company’s web site at or contact 131 694.

South East Water Corporation 25/09/2015 Page 1of 1