APPLICATION FORM Use for all resource consent and related planning applications (RMA, LGA, HASHAA)

Transcription

1 APPLICATION FORM Use for all resource consent and related planning applications (RMA, LGA, HASHAA) OFFICE USE ONLY: Application (s): Receipt date & time recorded: Deposit paid: RC APPLICANT USE ONLY: Application form complete & signed Deposit fee payment made: Supporting information attached: This form provides Western Bay of Plenty District Council with your contact details, and a brief outline about your proposal and its actual and potential effects on the environment. te that all the information provided in your application is available to the public. You will need to provide supporting information to accompany this application form. Please refer to the information requirements within the Resource Management Act 1991 and/or council s website for details on the required information to support your application. Where full information is not provided council may return incomplete applications. We recommend that you talk your proposal through with council staff before you fill in this form. If you have any questions, visit duty.planner@westernbay.govt.nz or phone us on PRE-APPLICATION INFORMATION Have you had a pre-application meeting with the council for your proposal? If yes: Date of meeting: Council officer/s: 2. APPLICATION TYPE NOTE: You may apply for two or more resource consents that are needed for the same activity on the same form. Please note for administrative purposes separate consent reference details will be created and fees for each application type will be required as set out in our fees and charges schedule. Land use s88 RMA Certificate of Compliance - s139 RMA Deemed Permitted Boundary Activity s87ba RMA Subdivision - s88 RMA Change or Cancel Consent Condition s127 RMA Survey Plan Approval - s223 RMA Existing Use Rights - s139a RMA Extension of Time s125 RMA Outline Plan of Works s176 RMA tice of Requirement or Alteration of Designation s168 or s181 RMA Easement cancellation or amendment s243 RMA Consent tice cancellation or variation s221(3) RMA Deposit of Survey Plan - s224 RMA ROW Approval s348 LGA Other (specify) e.g. NESCS, s357 Objection Fast Track consent (Land Use consent for a controlled activity) 3. SITE DETAILS Physical Address Street : Location: Legal Description(s): Street/Road: Opt in Opt out

2 4. CONTACT DETAILS NOTE: We will usually make contact with you through the consent process via , but may also need to post correspondence to the postal address you provide below (or another method of service as set out in s352 of the RMA) Applicant: Full name(s): Address for service: Postal Address: Agent/Consultant: t applicable: Name: Company: As above: Owner of Site to which application relates: Name: As above: Occupiers of the site to which the application relates: Name(s): Applicant: Agent: Owner: Written correspondence sent to: Invoices for processing fees sent to: Invoices for Financial Contributions (if applicable) sent to: NOTE: A minimum fee is payable on lodgement of all applications before Council will begin processing. An invoice will not be generated for this minimum fee payment. In some cases, this will be the whole cost of the application. In other cases an invoice will be issued at the time of decision for additional costs incurred. Page 2 of 5

3 5. DESCRIPTION OF PROPOSED ACTIVITY Provide a brief and clear description of your proposal: 6. OTHER ACTIVITIES Are there any other activities that are part of this application proposal? If yes, describe the other activities that are part of the proposal to which the application relates, including any permitted activities or activities addressed by other authorities or under other legislation: NOTE: For any activities that are permitted activities, provide a compliance schedule and/or other supporting information to explain how the activity complies with the requirements, conditions, and permissions of any Plan or regulation so that a resource consent is not required for that activity. 7. ADDITIONAL RESOURCE CONSENTS Are there any other resource consents required that do not form part of this application for this proposal? If yes, identify below, the other resource consents required that do not form part of this application: Resource consent required? Resource consent applied for? Land use consent Subdivision consent Cancellation or change of Conditions Easement cancellation/amendment s243 ROW approval Consent tice Cancellation s221(3) Regional Council Consent (Bay of Plenty Regional) Type: 8. CONSULTATION Have you consulted with Iwi? Have you consulted any other parties? If yes, please confirm who: Have you obtained the written approval of any potentially affected persons? NOTE: If yes, please ensure separate written approval(s) from the occupiers of the affected property as well as from the legal owners is provided. Evidence of ownership/authority to sign may be required. All owners are required to sign a written approval form or for multiple owned properties Council requires all trustees to sign unless written evidence is provided that authorises a trustee to sign on behalf of the trustees. 9. SITE VISIT REQUIREMENTS In order to assess your application it may be necessary for the Planner or Engineer to visit your site. This typically involves an outdoor inspection only, and there is no need for you to be home for this purpose. Do you require prior notice of any site visit? Are there any locked gates/security system restricting access? Are there any dogs on the property? Are there any other health and safety issues to be aware of? If yes, please provide details: Page 3 of 5

4 10. EXTENDING TIMEFRAMES NOTE: The Resource Management Act 1991 (RMA) specifies timeframes for processing resource consent applications (e.g. 20 working days for a non-notified application); however these timeframes can be extended, if necessary, with the Applicant s agreement. Do you agree to Council extending RMA consent processing timeframes?, provided that the extension is for the specific purpose of discussing and trying to agree on consent conditions., provided that the application process is completed before:. 11. SIGNATURE OF APPLICANT(S) OR AGENT NOTE: A signature is not required if the application is made by electronic means. If signing on behalf of a trust or company, please provide additional written evidence that you have signing authority. I hereby certify that, to the best of my knowledge and belief, the information given in this application is true and correct. I undertake to pay all actual and reasonable application costs incurred by the Western Bay of Plenty District Council. Applicants/Agent's Name: Applicants/Agent's Signature: Person authorised to sign on behalf of applicant Date: NOTES TO APPLICANT You must include all information required by this form. The information must be specified in sufficient detail to satisfy the purpose for which it is required. Incomplete applications will be returned. The Council may also request further information under Section 92 of the Resource Management Act 1991, to better understand the potential effects of the proposal. Processing of the application will be suspended until the further information is received. Further details on what information should be provided is available on Councils website. You must pay the charge payable to the consent authority for the resource consent application under the Resource Management Act 1991 (if any) All costs associated with processing the application over and above the minimum fee will be directly charged to the applicant. For discretionary or non-complying applications, Council may not be able to grant consent. In these cases all application fees are still payable. tes on fast-track resource consents: Under the fast-track resource consent process, notice of decision must be given within 10 working days after the date the application was first lodged with the authority, unless the applicant opts out of that process at the time of lodgement. A fast track application may cease to be a fast track application if the consent authority gives public or limited notification of the application or a hearing is to be held for the application If your proposal involves building work or change of use of a building you may also require a building consent under the Building Act This must be applied for separately. Other consents or licenses may also be required under such legislation as the Health Act 1956, the Food Act 2014 and the Sale and Supply of Alcohol Act 2012, dependent on the nature of the proposal. Page 4 of 5

5 If your application is to the Environmental Protection Agency, you may be required to pay actual and reasonable costs incurred in dealing with this matter (see section 149ZD of the RMA 1991). If you lodge the application with the Environmental Protection Authority, you must also lodge a notice in form 16A at the same time. HAVE YOU GOT EVERYTHING? NOTE: If your application does not include all relevant information when lodged with Council there is the potential that the application may be returned as incomplete and request additional information be provided before lodging again. To avoid the likelihood of this occurring (and time delays that can occur) it is important you include all the relevant information with your completed application form. Plans Computer Register (Certificate of Title) Assessment of Environmental Effects (AEE) NESCS Assessment Specific Application Information Fee Payment Written Approval Forms and/or Confirmation of Consultation Outcome Post: Person: LODGE COMPLETE APPLICATION BY: Consentsadmin@westernbay.govt.nz Consents Administration Team Policy, Planning & Regulatory Services Group Western Bay of Plenty District Council Private Bag Tauranga 3143 TAURANGA - Head Office Barkes Corner: 1484 Cameron Road KATIKATI - Katikati Library & Visitor Information Centre: 36 Main Road TE PUKE - Te Puke Library & Visitor Information Centre: 130 Jellicoe Street WAIHI BEACH - Waihi Beach Library & Service Centre: Waihi Beach Community Centre, Waihi Beach Road OMOKOROA Omokoroa Library & Service Centre: McDonnell Street Fees: The deposit fee payment required at the time of lodging for your application can be paid by cheque, credit card, EFTPOS, cash, online or telephone banking. Council s bank account details are: ANZ Tauranga 1st reference field: Applicant name 2nd reference field: Property address application relates to 3rd reference field: Property owner name Page 5 of 5