Development Services Application - PDF

Phone: 13 6992
Fax: 1300 862 066
Web: www.taswater.com.au
Email: development@taswater.com.au
Development Services Application
1. Title Address of Development
Unit /shop No.
Street No.
Lot No.
Street
Suburb
Postcode
Property
Identification
(PID)
Volume
Folio
State
Postcode
Details of work
proposed
2. Applicant / Agent Details
Applicant /
business name
Contact person
Postal address
Suburb
Business hours
(
phone no.
Nature of interest
in development
Email (certificate
to be sent by
email)
)
Mobile
Applicant /
agent’s signature
Date
3. Property Owner’s Details
As per applicant/agent’s details
Owner’s name
Contact person
Postal address
Suburb
Business hours
(
phone no.
State
)
Postcode
Mobile
Email
Property owner’s
signature
Development Services Application
Date
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April 2015
Phone: 13 6992
Fax: 1300 862 066
Web: www.taswater.com.au
Email: development@taswater.com.au
4. Billing Details
Applicant (default)
To be sent to
Property owner (must completed and signed by the property owner)
5.
Development Assessment /Application Type
Permit authority
(Council) reference
number
TasWater reference
number
Please note: A separate application is to be submitted for each stage of your development.
Water and/or sewerage service enquiry
Building & plumbing exemption application (Refer to statutory declaration page 3)
Certificate for certifiable work (building) and/or (plumbing)
56W Consent (for any works located within a TasWater easement or within 2m of TasWater
infrastructure)
#
Certificate of water and sewerage compliance (building) and/or (plumbing)
#
Engineering design approval
#
Permit to construct TasWater infrastructure
Water and sewerage connections
Water meter supply & installation only
#
Water connection or disconnection
#
Sewerage connection or disconnection
# Fields marked must have the relevant TasWater reference stated to ensure the application can be accepted.
6. Lodgement of Application
Applications may be submitted in person at any TasWater office or via::
Email (preferred):
development@taswater.com.au
Mail:
Development Services
GPO Box 1393
Hobart TAS 7001
7. Documents required when lodging this Application
Completed trade waste application form (if applicable)
Full copy of certificate of title documents
Planning permit (if applicable)
Any additional documents or information that may assist assessment
Detailed plans of the proposed development / works showing existing and proposed
TasWater assets, including connections
8. Privacy Statement
TasWater collects personal information for the purposes of providing water and sewer related services and products,
promoting such services and market research. We may disclose your personal information to our contractors for
these purposes and other third parties including local Councils, the Tasmanian State Government or its officers.
You may request access to your personal information that we hold by writing to the Privacy Officer at TasWater
Service Centre.
Please note we may charge a reasonable cost of providing you with access to your personal information.
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Phone: 13 6992
Fax: 1300 862 066
Web: www.taswater.com.au
Email: development@taswater.com.au
Statutory Declaration for Exemption Application
If answering ‘YES’ to ANY of the questions a Certificate for Certifiable Work (Building) and/or (Plumbing) is
required. If ‘NO’ to ALL questions, development is exempted. This form must be certified by an
authorised TasWater assessment officer to be valid.
Questions
Yes
No
Are new structures 2m or less from TasWater underground
services including eaves overhanging into that distance?
Is the development non-residential, commercial or industrial or
2
another process that generates Trade Waste to sewer?
Is the development non-residential, commercial or industrial or
3
another process that has or will require a connection to the
reticulated water supply?
Does the development increase the demand for water or
4
sewerage services or require an increase in connection size
Is the development within a water supply catchment or effect
5
water quantity or quality, i.e. dams, mining, subdivisions with
septic systems, dairies, plantations?
Is the development within a declared TasWater buffer zone,
6
i.e. near a sewerage treatment plant or water treatment plant?
Are any utilities or services being proposed to cross TasWater
7
water or sewerage infrastructure?
Is the application a subdivision of land, a strata title or a
8
consolidation of titles?
Does the proposal require a new water or sewer connection
9
i.e. no current services on the lot?
Is demolition of a structure or disconnection from TasWater
10
Mains infrastructure involved?
Statutory Declaration
1
In signing the statutory declaration against the requirements of the Water and Sewerage Industry Act 2008,
I declare that all questions have been answered truthfully. I make this solemn declaration under the Oaths
Act 2001.
Applicant /
agent’s
signature
Date
Name
TasWater Approval
Certifying officer:
Date:
Only valid upon completion by an authorised officer
Development
address
Suburb
Postcode
Details of
proposed
work
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