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APPLICATION FORM

APPLICATION               

THE APPLICANT

Given Names:                   

Surname:                         

Address:                           

Contact No.:                      

THE OWNER/S

Owner 1

Given Names:                   

Surname:                         

Address:                           

Contact No.:                      

Owner 2

Given Names:                   

Surname:                         

Address:                           

Contact No.:                      

Owner 3

Given Names:                   

Surname:                         

Address:                           

Contact No.:                      

Owner 4

Given Names:                   

Surname:                         

Address:                           

Contact No.:                      

THE LAND TO BE DEVELOPED

Lot No.:                             

DP No.:                             

House No.:                        

Street Name:                     

Suburb:                             

Post Code:                         

Area of the Site:                 

DESCRIPTION OF THE DEVELOPMENT

Proposed work:                  

Description:                       

Value of the Work:             

BCA Classification:        

DEVELOPMENT CONSENT

Development Consent No:  

Date of Determination:          

THE BUILDER

Name:                               

Address:                            

Contact No:                        

Licence No.: