1B - Application Notice of Agreement (Non-Works)
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24 Hour Emergency Service, Faults & Enquiries 1800 061 514 chw.net.au APPLICATON FORM 7 Learmonth Road, Wendouree VIC 3355 | PO BOX 152 Ballarat VIC 3353 DX 35024 | ABN: 75 224 340 348 Notice of Agreement (Non-Works) Please provide details of all conditions necessary to provide water supply and/or sewerage facilities for the development detailed below. The Developer/Consultant/Owner nominated is responsible for the project management of Central Highlands Water requirements needed for the development. A fee of $158.67 will apply for this application. Development details Address: City/Suburb: Number of lots: Staged subdivision?: Yes No Postcode: Type of subdivision: e.g. Residential/Commercial. Applicant details Name: Address: Suburb: Phone: Postcode: Email: Additional information Will the units/development be part of an Owners Corporation? Yes No If the development is not going to be part of an Owners Corporation please contact us to discuss When will the proposal commence?: If applicable, when is the completion date for the proposed dwellings?: (For rating purposes)
Transcript of 1B - Application Notice of Agreement (Non-Works)
24 Hour Emergency Service, Faults & Enquiries 1800 061 514 chw.net.au
APPLICATON FORM 7 Learmonth Road, Wendouree VIC 3355 | PO BOX 152 Ballarat VIC 3353 DX 35024 | ABN: 75 224 340 348
Notice of Agreement (Non-Works) Please provide details of all conditions necessary to provide water supply and/or sewerage facilities for the development detailed below. The Developer/Consultant/Owner nominated is responsible for the project management of Central Highlands Water requirements needed for the development.
A fee of $158.67 will apply for this application.
Development details
Address: City/Suburb: Number of lots: Staged subdivision?: Yes No
Postcode: Type of subdivision: e.g. Residential/Commercial.
Applicant details
Name: Address: Suburb: Phone:
Postcode: Email:
Additional information
Will the units/development be part of an Owners Corporation? Yes No If the development is not going to be part of an Owners Corporation please contact us to discuss
When will the proposal commence?:
If applicable, when is the completion date for the proposed dwellings?: (For rating purposes)
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24 Hour Emergency Service, Faults & Enquiries 1800 061 514 chw.net.au
Supporting documentation
Please attach the following (if applicable) Plan of development indicating proposed or existing buildings. Plan of subdivision. Copy of planning permit from Council or Shire.
Developer’s (owner’s) signature
Signature of Developer:
Date:
