Application for Amendment of Environmental Authorisation in terms of the National Environmental Management Act, 1998 (Act No. 107 of 1998), as amended and the Environmental Impact Assessment Regulations, 2010

(For official use only)
File Reference Number:
NEAS Reference Number:
Date Received:
Responsible Official:

When to use this form

This form must be used to apply for the amendment of an environmental authorisation, and must be submitted if a) there is a material change in the circumstances which existed at the time of the granting of the environmental authorisation; b) there has been a change in ownership in the property and transfer of rights and obligations must be provided for; c) any detail contained in the environmental authorisation must be amended, added, substituted, corrected, removed or updated.

Note: an extension of the time period for which an environmental authorisation is valid is regarded as an amendment of a condition contained in the environmental authorisation.

Kindly note that:

  1. This application form is current as of 1 April 2014. It is the responsibility of the EAP/applicant to ascertain whether subsequent versions of the form have been published or produced by the competent authority.
  1. The requiredinformation must be typed within the spaces provided in the form. The sizes of the spaces provided are not necessarily indicative of the amount of information to be provided. It is in the form of a table that can extend itself as each space is filled with typing.
  1. Incomplete applications may be rejected or returned to the applicant for revision.
  1. The use of “not applicable” in the form must be done with circumspection as if it is used in respect of material information that is required by the competent authority for assessing the application, and may result in the rejection of the application as provided for in the regulations.
  1. This form must be submitted to the Department at the relevant DISTRICT OFFICE given below.Should the application form not be submitted at the relevant district office, it will not be considered.
  1. No faxed or e-mailed applications will be accepted.
  1. A certified copy of the environmental authorisation in respect of which an amendment is applied for must be attached to this document.
  1. Proof of payment of the applicable fee for consideration and processing of applications must accompany the submission of this form, unless an exclusion applies.
  1. Unless protected by law, all information contained in and attached to this application, will become public information on receipt by the competent authority. Upon request during any stage of the application process, the applicant / EAP must provide any registered interested and affected party with the information contained in and attached to this application.

EHLANZENI DISTRICT
(Nedbank Building, 30 Brown Street, Nelspruit) / NKANGALA DISTRICT
(Cnr Rosemead and Ryan Road, Witbank) / GERT SIBANDE DISTRICT
(13 De Jager Street, Ermelo)
Environmental Impact Management
Nedbank Building (6th floor)
30 Brown Street
Nelspruit
1200
Tel: 013 766 4802 / Environmental Impact Management
P. O. Box 7255
Witbank
1035
Tel: 013 692 5843 / Environmental Impact Management
P. O. Box 2777
Ermelo
2351
Tel: 017 811 3954

proof of payment

Tick the appropriate box below to indicate that either proof of payment of the prescribed fee of R2000is attached or that, in the applicant’s view, an exclusion applies. Proof and motivations for exclusions must be attached to this application form.

Proof of payment attached:
Exclusion applies:

An applicant is excluded from paying fees if:

  • The activity is a community based project funded by a government grant; or
  • The applicant is an organ of state

TYPE OF EXCLUSION / Tick which is applicable and attach proof / motivation
The activity is a community based project funded by a government grant
The applicant is an organ of state

Details for the payment of application fees

Payment Enquiries:
Contact person: Sipho Mabuza
Tel: 013 766 4589
Email:
Banking Details:
Standard Bank
Branch Code: 052852 (Nelspruit)
Account number: 0328 93132
Reference number: The following reference number must be used depending on the district within which the environmental authorisation was issued:
EHLANZENI / GERT SIBANDE / NKANGALA
AEH / AGS / ANK
Proof of payment must be attached to this application form.
“Proof of payment” includes a receipt, a stamped deposit slip, electronic fund transfer copy or a payment advice.
Tax exemption status:
Status: Tax exempted

1.background information

1.1Details relating to the environmental authorisation

Environmental authorisation number in respect of which an amendment is applied for:
A certified copy of the environmental authorisation must be attached to this application
Date of issue of environmental authorisation:
Project Title:
Specific activity/ies for which authorisation was granted:
Property description:
Farm name, portion, number and registration division or Erf number etc.) Where a large number of properties are involved (e.g. linear activities), please attach a full list to this application.

1.2Details of the holder of the environmental authorisation

Name of person to whom the environmental authorisation was issued:
Trading name (if any):
Contact person:
Postal address:
Postal code: / Cell:
Telephone: / Fax:
E-mail:

1.3Details of the environmental assessment practitioner

Name of environmental assessment practitioner that undertook the previous EIA process
If an environmental assessment practitioner is being used, name of EAP assisting the applicant in the current amendment application:
Contact person:
Postal address:
Postal code: / Cell:
Telephone: / Fax:
E-mail:
Qualifications & relevant experience
Professional affiliation(s) (if any)

1.4Details of landowner

Name of landowner if the person to whom the environmental authorisation has been issued is not the owner:
Contact person:
Postal address:
Postal code: / Cell:
Telephone: / Fax:
E-mail:
Has the owner been informed of this application?
If there is more than one landowner, please attach a list of landowners with their contact details to this application.

2.DETAILS OF IMPLEMENTATION OF PREVIOUS ENVIRONMENTAL AUTHORISATION

Was the authorised listed activity(ies) commenced with during the validity period of the environmental authorisation? If yes, please describe the implementation of the previous environmental authorisation to date with specific reference to the authorised listed activity(ies): / YES / NO

3.AMENDMENTS APPLIED FOR AND RELATED INFORMATION

3.1Type of application

Indicate which of the following is relevant:

a) there is a material change in the circumstances which existed at the time of the granting of the environmental authorisation / YES / NO
b) there has been a change in ownership in the property and transfer of rights and obligations must be provided for; or / YES / NO
c) any detail contained in the environmental authorisation must be amended, added, substituted, corrected, removed or updated / YES / NO

Should the amendment being requested result due to 3.1(b) above, you must provide a written undertaking that the new holder of the environmental authorisation is willing and able to assume responsibility of the environmental authorisation issued.

3.2Amendments requested

Describe the amendments that are being applied for andprovide reasons/ motivation for the application for amendment.

Amendment requested / Reason / Motivation

4.ENVIRONMENTAL IMPACTS

4.1Describe any negative environmental impacts that may occur if the application is granted. Information on any increases in air emissions, waste generation, discharges to water and impacts of the natural or cultural environment must be included.

4.2 Describe any negative environmental impacts that may occur if the application is not granted.

2.3Describe any positive environmental impacts that may occur if the application is granted. Information on any reduction in the ecological footprint, air emissions, waste generation and discharges to water must be included.

5.AUTHORISATION FROM OTHER GOVERNMENT DEPARTMENTS

Are any permissions, licenses or other authorisations required from any other departments before the requested amendments can be effected? / YES / NO

If yes, please complete the table below.

Name of department and contact person / Type of authorisation required / Authorisation applied for (yes/ no)

6.RIGHTS AND INTERESTS OF OTHER PARTIES

In your opinion, will the rights or interests of other parties be adversely affected by the granting of the application? / YES / NO

Provide a detailed motivation of your opinion.

NOTE:

The Department is entitled to request further information if it believes it is necessary for the consideration of the application. If the application is for a substantive amendment or if the rights or interests of other parties are likely to be adversely affected, the Department will instruct the applicant toconduct a public participation process and to conduct any investigations and assessments that it deems necessary.

D.DECLARATION

I, ______, -

declare that the information in this application form, including any attachment, is not false or misleading in any material manner.

Signature of the applicant and position if the applicant is a legal entity:

Name of company:

Date:

Signature of the Commissioner of Oaths:

Date:

Designation:

Official stamp (below):

Version 2: 1 April 20141