METRO TUNNEL PROPERTY PRE-CONDITION SURVEY PERMISSION TO PROCEED FORM

I/we hereby give our permission for Cross Yarra Partnership and their nominated building inspector (to be advised on receipt of completed form) to carry out a property pre-condition survey of my/our property. I/we understand that there is no cost involved.

Please complete Parts A, B, C and D (if applicable) below.

PART A: Address of property to be surveyedProperty Address Apartment: _________ 400 St Kilda Rd Melbourne

PART B: Person agreeing to survey (please print)

Name:

Address: (if different from above)

Preferred Contact Number(s):

Preferred Contact Time: Day Evening

Email:

Signature: Date:

Part C: Your connection with the property (please tick relevant box below)

Owner Occupier

Owner (or Agent)

Tenant

PART D: Other relevant contact details for leased properties:If you are an owner please fill out the agent’s/tenant’s details

Name: ……………………………………………………………………………………………………

Address: …………………………………………………………………………………………………

Phone Number: …………………………………………………………………………………………

If you are a tenant please fill out the agent’s/owner’s details

Name: …………………………………………………………………………………………………….

Address: ………………………………………………………………………………………………….

Phone Number: ………………………………………………………………………………………….