Applicant and Owner Details Provide details of the applicant and the owner of the land. Applicant * Name: The person who wants the permit. Postal Address: If it is a P.O. Box, enter the details here: Unit No.: St. No.: St. Name: Suburb/Locality: Postcode: Please provide at least one contact Contact information for applicant OR contact person below phone number * Where the preferred contact person for the application is Contact person’s details* Same as applicant Name: different from the applicant, provide the details of that person. Title: First Name: Surname: Organisation (if applicable): Postal Address: If it is a P.O. Box, enter the details here: Unit No.: St. No.: St. Name: Suburb/Locality: State: Postcode: the details of that person or Owner * Postal Address: The person or organisation If it is a P.O. Box, enter the who owns the land details here: Name: Where the owner is different from the applicant, provide Same as applicant organisation. Unit No.: St. No.: St. Name: Suburb/Locality: State: Postcode: Signature (Optional): Date: day / / year Declaration This form must be signed by the applicant* Remember it is against the law I declare that I am the applicant; that all the information in this application is true and correct; that to provide false or misleading all changes to the permit and plan have been listed as part of the amended proposal and that the owner information, which could result in (if not myself) has been notified of the permit application. a heavy fine and cancellation of the permit. Signature: Date: day / month / year Need help with the Application? If you need help to complete this form, read More Information at the end of this form or contact Council’s planning department. General information about the planning process is available at Contact Council’s planning department to discuss the specific requirements for this application and obtain a checklist. Insufficient or unclear information may delay your application. Has there been a pre-application meeting with a council planning officer? No Yes If with whom?: ‘Yes’,
Applicant and Owner Details Provide details of the applicant and the owner of the land. Applicant * The person who wants the permit. Name: Postal Address: If it is a P.O. Box, enter the details here: Unit No.: St. No.: St. Name: Suburb/Locality: Postcode: Please provide at least one contact phone number * Contact information for applicant OR contact person below Where the preferred contact person for the application is different from the applicant, provide the details of that person. Contact person’s details* Same as applicant Name: Title: First Name: Surname: Organisation (if applicable): Postal Address: If it is a P.O. Box, enter the details here: Unit No.: St. No.: St. Name: Suburb/Locality: State: Postcode: Owner * The person or organisation who owns the land Where the owner is different from the applicant, provide the details of that person or Name: Postal Address: If it is a P.O. Box, enter the details here: Same as applicant organisation. Unit No.: St. No.: St. Name: Suburb/Locality: State: Postcode: Signature (Optional): Date: day / / year Declaration This form must be signed by the applicant* Remember it is against the law to provide false or misleading information, which could result in a heavy fine and cancellation of the permit. I declare that I am the applicant; that all the information in this application is true and correct; that all changes to the permit and plan have been listed as part of the amended proposal and that the owner (if not myself) has been notified of the permit application. Signature: Date: day / month / year Need help with the Application? If you need help to complete this form, read More Information at the end of this form or contact Council’s planning department. General information about the planning process is available at Contact Council’s planning department to discuss the specific requirements for this application and obtain a checklist. Insufficient or unclear information may delay your application. Has there been a pre-application meeting with a council planning officer? No Yes If ‘Yes’, with whom?:
application-to-amend-a-planning-permit-macedon-ranges-shire-council.docx