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APPLICATION FOR DEVELOPMENT

Environmental Planning & Assessment Act 1979

1. APPLICANT

Applicant’s name(s):

Full postal address: Postcode:

Phone (day): Mobile:

Email address:

2. LAND TO BE DEVELOPED

Street no.: Street/road:

Locality/town: Lot no.: Deposited/strata plan:

Section no.: Parish:

3. PROPOSED DEVELOPMENT

Use of land/buildings Erection of buildings

Carrying out of work Alterations/additions

Subdivision of and/building

Demolition Other (please state)

Description (eg, dwelling house)

Proposed use (eg, residential)

Estimated cost $ Existing development on land 4. ALTERNATE TYPE OF CONSENT (if you wish to apply for a deferred or concept development, please ✓ the appropriate box)

Deferred commencement Concept development

5. APPROVALS UNDER SECTION 68 LOCAL GOVERNMENT ACT 1993

Does this proposal also require approval for one or more of the following activities?

Connect to Council’s sewerage system

Install a septic tank or other onsite waste disposal system (additional information must be lodged for this activity)

Connect to Council’s water supply (a water connection card should be completed and lodged for this activity)

Other

6. INTEGRATED DEVELOPMENT

If approval is required under one or more Acts, a copy of this application will be submitted to each relevant approval body by Council. Refer to S91 requirements of the Environmental Planning & Assessment Act 1979. You must provide a cheque or money order made payable to each relevant approval body.

Does this proposal require additional approval as integrated development? YES NO

7. CONCURRENCIES FROM STATE AGENCIES

Do you need the concurrence of a State agency to carry out the development? YES NO

If YES, please list any agency whose concurrency you require:

8. ENVIRONMENTAL EFFECTS OF YOUR DEVELOPMENT

Is the land, or is part of the land, critical habitat? YES NO

Cnr Campbell St & Vulcan St PO Box 99 MORUYA NSW 2537

Telephone: 02 4474 1000 Facsimile: 02 4474 1234

E: council@esc.nsw.gov.au www.esc.nsw.gov.au

Council’s ‘Development process’ provides a guide on how to complete this application NOTE: THIS FORM SHOULD BE LODGED WITH A STATEMENT OF ENVIRONMENTAL EFFECTS AND THE RELEVANT CHECKLIST.

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Is your proposal likely to significantly impact on threatened species, populations, ecological communities or their habitats?

YES NO If YES, please attach a Species Impact Statement (see division 5 of the Biodiversity Conservation Act 2016).

9. BIODIVERSITY (IF APPLICABLE)

Is your development biodiversity compliant? YES NO (refer to Council’s web page, ‘Removal of trees/vegetation').

If YES, state why the development is biodiversity compliant:

Is the application accompanied by a biodiversity development assessment report? YES NO

Is the land subject to a private land conservation agreement under the Biodiversity Conservation Act 2016? YES NO If YES, please provide a copy of the agreement.

10. PRIVACY POLICY

The information you provide in this application will enable your application to be assessed by Council and any relevant State agency. If the information is not provided, your application may not be accepted. Depending on your proposal, your application may be advertised for public comment. Council will include your application in a register that can be viewed by the public at any time. Please contact Council if the information you have provided in your application is incorrect or changes.

11. COPYRIGHT AND PRIVACY CONSENT

I am authorised by the copyright owner of any material submitted with this application to provide this material to Council. In doing so, I understand, and the copyright owner acknowledges, that this material may be made publicly available at Council’s offices, on Council’s website and to third parties on request both during and after the assessment is completed.

12. POLITICAL DISCLOSURE

Have you, the owner, or any person with a financial interest in this application, made a political donation to a councillor or Council employee in the past two years?

YES NO

13. CONSENT OF ALL OWNERS

As the owner(s) of the property, I/we consent to this application to apply for approval to carry out the development described herein and state that the information contained herein is, to the best of my/our knowledge, true and correct. I/we hereby give permission for Council authorised personnel to carry out inspections of the land and buildings as necessary for the purpose of assessing this application without prior notice of entry.

Names:

Signature(s): Date:

14. APPLICANT’S DECLARATION (or person signing on behalf of applicant – please state in what capacity)

I/we, the undersigned, hereby apply for approval of the development proposal described in this application and in the plans, specifications and documents accompanying this application. I/we undertake to develop in accordance with any approval granted by Council and conform with the provisions of the relevant Act(s), Regulations, Codes and Local Environmental Plans.

Signature(s):

Name, if not applicant

Capacity, if not applicant Date:

OFFICE USE ONLY

DA no. Development $ Construction Cert. $

CC no. Subdivision $ Compliance insp. $

Sewer no. Consent advertising $ OSMS $

File no. Planning NSW $ Notice of Works $

Zone Integrated development $ Plumbing compliance $

Area (m²) Advertising $ S68 moveable dwelling $

Census code Variation $ Building Certificate $

Pin no. Existing unapproved $ Long service levy $

Water meter $ TOTAL $

Receipt no. Date: / /20

No. of compliance insp. No. of plumbing insp.

Cnr Campbell St and Vulcan St PO Box 99 MORUYA NSW 2537

Telephone: 02 4474 1000 E: council@esc.nsw.gov.au

www.esc.nsw.gov.au

STATEMENT OF ENVIRONMENTAL EFFECTS For class 1 and 10 buildings

NOTE: THIS FORM SHOULD BE LODGED WITH AN APPLICATION FOR DEVELOPMENT & THE RELEVANT CHECKLIST.

APPLICANT DETAILS

Applicant’s name(s):

LAND DETAILS

No.: Street/road:

Town: Lot no.: Deposited/Strata Plan:

DETAILS OF DEVELOPMENT

Provide a description of the development.

Provide a brief analysis of the site, including:

a general description of the site and its surroundings

the size and scale of adjacent properties and the materials they are constructed from.

Describe what steps you have taken to ensure that the proposal sits comfortably within the surrounding area described above.

SUITABILITY OF LAND

Is the site affected by flooding, drainage, land slip, soil erosion or similar constraints? YES NO

If YES, specify which.

What will be done to overcome these constraints?

COMPLIANCE WITH COUNCIL REQUIREMENTS

Council will assess your proposal against the relevant policies within the Local Environmental Plan (LEP) and Development Control Plan (DCP). You can refer to Council’s LEP and DCP web pages to check which plan and DCP applies to your land. If your proposal is not in accordance with all of the policy requirements, then you should provide a justification as to why (making reference to the policies).

Demonstrate compliance with the acceptable solution(s) and/or justification of how the development meets performance criteria.

You may wish to attach a full review of the DCP and LEP, or refer to the claim against performance criteria form.

If you answered ‘NO’, provide justification:

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PRIVACY, VIEWS, OVERSHADOWING, NOISE AND IMPACT

What development exists on neighbouring properties?

How does the proposal ensure that there is no:

a) loss of privacy to neighbouring properties? (Consider: placement of windows; views between main rooms and private areas, ie, yard; use of screening, planting & fences to improve privacy; decks, terraces & balconies can be intrusive if not sensitively designed).

b) unacceptable noise impact on neighbouring properties? (Consider: distances between buildings; location of new outdoor areas; vehicular movement; placement of air conditioners, pumps & new room windows that could open; acoustic treatment such as pump rooms or fencing).

c) overshadowing of neighbouring properties? (Consider: analysis of shadowing, including diagrams to show effects on adjoining properties; distances between buildings; existing shadowing from existing buildings or structures).

d) loss of views from neighbouring properties? (Consider: impact of development on views from adjoining or nearby buildings; design options for protecting views).

Is the proposal compatible with the bulk, scale and character of the neighbourhood?

YES NO

If NO to the above, what measures have been taken to minimise the effect of this impact?

VEGETATION REMOVAL/BIODIVERSITY ASSESSMENT REPORT A vegetation removal plan must be included in your application and must include m2 of clearing, including the entire APZ and associated clearing, ie, access roads, fencing etc, required for your development.

YES NO

Are you exceeding the Biodiversity Offsets Scheme thresholds or is your property mapped on the Biodiversity Values Map? If yes to either, a Biodiversity Assessment Report must be supplied with this application.

YES NO

For more information, refer to the ‘Biodiversity Offsets Scheme fact sheet’.

ACCESS AND TRAFFIC

Estimate the amount of traffic generated by the development:

Vehicles

per day:

Does the proposal involve any new access arrangements to the site? If YES, please provide details of the new arrangements and ensure they are clearly marked on the plans.

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ACCESS AND TRAFFIC - CONTINUED

What provisions have been made for:

a) entrances/exits on the site?

b) car parking and manoeuvring areas?

c) number of parking spaces to be provided?

d) loading/unloading areas?

e) waste collection areas?

Does the proposal introduce new vehicle types to the site? If YES, please provide details.

NB: a traffic statement or study may be required for certain types of development.

SERVICES

Are the following services available and adequate for the proposed development? If NO, provide details of action to

be taken (if insufficient space, please provide further details on separate sheet).

Water: YES NO

Power: YES NO

Electricity: YES NO

Drainage: YES NO

Phone: YES NO

STORMWATER AND SEWERAGE

How will stormwater be disposed of - existing Council drainage system or other? (Please ensure that details are provided on the plans

as required).

How will sewerage be disposed of - to existing sewer or onsite system (ie, septic tank)? How will this onsite system be disposed of? (Please provide details on how it will be moved off-site both in this

document and on your plans).

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CONTAMINATION

Have there been any activities or historic uses that could have contaminated the site to the best of your knowledge?

NO

If so, please provide details, providing as much information as possible.

Have there been any attempts to address this contamination? If so, please provide details.

DEMOLITION AND ASBESTOS (IF APPLICABLE)

Does the proposal involve the demolition of any buildings or other structures?

YES NO

If YES, please describe what is being demolished.

How will the waste material be disposed of?

Is there any known asbestos material on the site that will be disturbed as a result of the demolition works? If YES, please provide details of how this will be disposed of.

CUT AND FILL (IF APPLICABLE)

Does the proposal involve any cut and fill of more than 600mm across the site?

YES NO

If YES, please provide details on the extent of the cut and fill and ensure that this is shown clearly on the plans.

How will the importing or removal of material to the site be managed?

Please provide details of how any surface of stormwater arising from the cut and fill will be dealt with within the site.

CONSTRUCTION MANAGEMENT PLAN

Please provide details on how any potential impacts during construction will be reduced (please consider noise, dust, traffic,

hours of work and deliveries).

Please provide any other details that you consider will be relevant to the determination of your application that have not been covered elsewhere.

ONGOING WASTE MANAGEMENT

Please provide details of the likely ongoing waste management arrangements for the proposal. This includes bin storage area and access, bin types and whether onsite or kerbside pickup.

OTHER DETAILS

Please provide any other details that you consider will be relevant to the determination of your application that have not been covered elsewhere.

YES