Applicant Details

Council is collecting the information on this form so that it may consider your application. The information is only used by Council for this purpose and will not be disclosed unless required under law.

Applicant Details

Name: Surname:

Company (if applicable):

Postal Address: Post Code:

Telephone: Mobile:

Email: Your Ref:

Property Details (please provide a current copy of title)

Address:

City/ Town/Suburb: Post Code:

Lot: LP/PS: Vol/Fol:

Proposed Works (if applicable):

Information Requested under Regulation 326

Information / Fee (each) / Please tick
(1)  In respect to any building or land
a)  Details of any permit or certificate of final inspection in the preceding 10 years; and
b)  Details of any current statement issued under regulation 502 or 503 of these regulations; and
c)  Details of any current notice or order issued by the relevant building surveyor under the Act. / $51.10 / ☐
(2)  Whether the building or land is in an area
a)  That is liable to flooding within the meaning of regulation 802; or
b)  That is designated under regulation 803 as an area in which buildings are likely to be subjected to attack by termites; or
c)  That is determined under regulation 810 to be a designated bushfire prone area; or
d)  That is an area determined under regulation 805 is likely to be subject to significant snowfalls; or
e)  Of designated land or works within the meaning of regulation 806. / $51.10 / ☐
Town Planning (If applicable please provide proposed construction plans): Is a Planning Permit Required for the above proposed works? / N/A / ☐
(3)  Inspection approval dates of the mandatory notification stages for building work carried out on that building or land. Note: This information can only be provided to an owner or mortgagee or a prescribed building practitioner under Section 137B of the Building Act 1993. / $51.10 / ☐

Payment & Lodgement

Payments can be made (tick applicable):

☐ In Person: Civic Centre, 25 Liebig Street, Warrnambool.

☐ Cheque/Money Order: (enclosed & payable to Warrnambool City Council).

☐ Credit Card: If you wish to pay for your permit application by credit card, please tick the box & Customer Service staff will ring you upon receipt of your enquiry to arrange payment.

Lodgements can be made:

By post to: PO Box 198, Warrnambool Victoria 3280

In Person at: Civic Centre, 25 Liebig Street, Warrnambool

By email to:

Civic Centre 25 Liebig St Telephone (03) 5559 4800 Website www.warrnambool.vic.gov.au

Warrnambool Victoria Australia Facsimile (03) 5559 4900 ABN 44 594 264 321

P.O. Box 198 Warrnambool VIC 3280 AUSDOC DX 28005