(PRE-LODGEMENT MEETING)
Environmental Planning and Assessment Act 1979
Environmental Planning and Assessment Regulation 2000
Locked Bag 155, Coffs Harbour 2450;
Customer Service Centre, 2 Castle Street, Coffs Harbour
Email: Phone: (02) 6648 4000
Website: www.coffsharbour.nsw.gov.au ABN 79 126 214 487
This form may be used to arrange a pre-lodgement meeting with Council in relation to requests for amendments to Coffs Harbour Local Environmental Plan (LEP) 2013. To complete the form, please place a cross in the boxes and fill out all sections.
Failure to complete the application form correctly or provide all necessary information will result in delays in processing a meeting booking.
Step 1. Details of the applicant/s Note: Council will liaise with and send all related information to this contact
Mr Ms Mrs Other
Given name/s / Surname
Company/organisation
Contact Name Daytime Contact Number
Mobile E-mail
Step 2. Description of property (if relevant) Note: Council requires this to correctly identify the property
Unit/Street No. / Street Name
Suburb or Town / Postcode
Lot/DP or Lot/Section/DP or Lot/Strata no. / Owner/s
Step 3. Requested Amendment to Coffs Harbour Local Environmental Plan 2013
Description of Requested Amendment: Please attach another page if required.
Step 4. Brief description of issues for consideration & justification for requests
Issues and Justification: Please attach another page if required.
Step 5. Supporting Information
Concept plans
Detailed description of proposal
Step 6. Attendees
Number of people who will be in attendance at the meeting
Note: this includes the owner and/or applicant
Step7. Preferred Meeting Time
10:00am
2:00pm
Preferred day of the week:
Step 8. Applicable fees and charges
Pre-lodgment meetings are not confirmed until payment of the associated fee is made to Council. To view the applicable fees and charges associated with this application please refer to Council’s adopted fees and charges at www.coffsharbour.nsw.gov.au/fees
Step 9. Privacy and personal information protection notice
· this information is voluntarily required to process your request and will not be used for any other purpose without seeking your consent, or as required by law;
· your information may comprise part of a public register related to this purpose;
· your application will be retained in Council’s Records Management System and disposed of in accordance with the Local Government Disposal Authority;
· your personal information can be accessed and corrected at any time by contacting this Council.
Applicant’s Signature/s
I declare that to the best of my knowledge all particulars supplied by me are correct and completed. I understand that inaccurate or false statements may cause my application to be delayed or rescinded.
Signature/s : …………………………………………………………………………… Date: ……/……./…….
Office Use Only / 321008-1001-41171
Date received / Application fee (if applicable) / Receipt No.
Request to Amend Coffs Harbour LEP 2013- (Pre-lodgement Meeting) [FRM – E162] 03/04/2017