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Application for Resource Consent (Form 9)

1.0 General Details

Land Use Consent Subdivision Consent Certificate ofCompliance (s139)

Controlled

The activity type is:

Qualifying Development Land Use Consent (Special Housing Area)

Qualifying Development Subdivision Consent (Special Housing Area)

Subdivision Related

3.0 Applicant Details (In principle all invoices will be sent to the applicant unless otherwise stated – see below)

Non-Complying

Not applicable

Physical Address:

Owner’s Name:

Owner’s Address:

Occupier’s Name:

Occupier’s Address:

N

ompany/Trustee Name:

Postal Address:

Postal code:

Phone (day): (mobile):

Email:

Under the Resource Management Act 1991 or the Local Government Act 1974

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4.0 Agent/Consultant Details (In principle all correspondence will be sent to the agent unless otherwise stated – see below)

5.0 Address for Correspondence and Invoices

Company/Name:

Contact Person:

Postal Address of Agent: Postal code:

Phone (business): (mobile):

Email: Fax:

Company/Name:

Postal Address:

Email:

Company/Name:

Postal Address:

Email:

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9.0 Site Visit Requirements

Land Use Consent Subdivision Consent Other Consent Authority

Details:

with Council?

Yes No

If "#$

%&

If applicant is not the landowner:

Landowner’s full name:

Landowner’s signature: Date Signed:

Person authorised to sign on behalf of Landowner:

Authorising person’s signature: Date Signed:

Yes No

Do you have a dog on the property? Yes No

Is there any hazard that may place a visitor at risk? Yes No

organic farm etc.

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12.0 Deposits

or more than minor (but not less than minor)” and who have not

If "#$

not exceed 25MB) to planning.guidance@hcc.govt.nz

The following (1) resource consent deposit fee and (2) engineering deposit fee (where applicable); for the

Direct Credit Cash, Credit card or EFTPOS via Municipal Building Cheque

I/we understand that Council may invoice me for the actual and reasonable costs incurred in the processing

Engineering Deposit Fee: $ (where applicable)

If paying by cheque, a combined payment is acceptable.

For a list of fees and charges visit www.hamilton.govt.nz. Payment can be made by cash, EFTPOS or credit card at the Municipal Building, Garden Place or by direct credit 02-0316-0030142-006. If paying by direct credit, please quote Planning, Code: Name of Applicant, Reference:

Yes No

Yes No

Yes N/A

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14.0 Signature of Applicant for Resource Consent

I/we understand that the Council may charge me/us for all costs actually and reasonably incurred in processingthis application. Subject to my/our rights under sections 357B and 358 of the RMA or section 81 of the HASHAAto object to any costs, I/we undertake to pay all and future processing costs incurred by the Council. Without limiting the Council’s legal rights, if any steps, including the use of debt collectors, are necessary to recover unpaid processing costs, I/we agree to pay all costs of recovering those processing costs. If this application is made on behalf of a trust (private or family), a society (incorporated or unincorporated) or a company, in signing this application I/we are binding the trust, society or company to pay all the above costs and guaranteeing to pay all the above costs in my/our personal capacity.

Full name:

Address: Postcode:

Signature: Date Signed:

Full name:

Signature: Date Signed:

Send

Garden Place , between 8am and 4.45pm Monday – Friday or post to:

Planning Guidance ManagerPlanning Guidance UnitHamilton City CouncilPrivate Bag 3010Hamilton 3240

PRIVACY INFORMATION:

may also be made available to the public on the Council’s website. These details are collected to inform the general public and community

please contact the Council.

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I/we understand thatI/we understand that the Council may charge me/us for all costs actually and reasonably incurred in processingthis application. Subject to my/our rights under sections 357B and 358 of the RMA to object to any costs, I/weundertake to pay all and future processing costs incurred by the Council. Without limiting the Council’s legalrights, if any steps, including the use of debt collectors, are necessary to recover unpaid processing costs, I/weagree to pay all costs of recovering those processing costs. If this application is made on behalf of a trust (privateor family), a society (incorporated or unincorporated) or a company, in signing this application I/we are bindingthe trust, society or company to pay all the above costs and guaranteeing to pay all the above costs in my/ourpersonal capacity.

of a resource consent (LGA (2002) sec 198(a)).

Consent

Impermeable surface area

Land use consent Subdivision consent Other

Address of development:

Gross site area:

Zone:

m" Proposed: m"

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(please complete as applicable)

Proposed development on site (please complete as applicable)

(please sign)

Name: Date:

Signature:

m²/units To be removed Date last occupied

300m² July 2010

m²/units

8 units