Section 221 Application Form

Required fields are marked with an asterisk (*).

Applicant Details

Property Owner's Name: *

Property Owner's Address:

Property Owner's Phone:

Applicant's Name: (If not same as above)

Applicant's Address: (if not same as above) *

Applicant's/Owner's Email: *

Applicant's Phone: *

Does this Application Relate to a Development Application (DA)? *

If yes - What is the Development Application number?

Location of Proposed Works

Street Address: *

Certificate of title (If known)

Property Type (Council verge, park or reserve, carpark):

Type of Proposed Works

Type of Proposed Works (tick all that apply) *

If other, please specify:

Documents attached - Please provide copies of the following documents

Locality Plan showing the location of the site *

Traffic Management Plan showing all signage and traffic control devices

Dimensioned Works Plan showing all features and proposed alteration. *

Certificate of Currency of Public Liability Insurance