Public Land manager Consent Request

Property Location

Property name

Property Address

Have you discussed the work with a Council Officer

YesNo

If Yes, who did you speak with?

Has an Application for the project previously been submitted to Council for consent?

YesNo

If Yes, what year was it submitted?

Has the application been discussed with facility co-tenant/s?

YesNo

If yes, who was it discussed with?

Description of the works

Structural works: are there any?

Who will carry out the work?

What is the issue or need for the project?

Does the project address any risks or safety issues?

What is the estimated cost of the project?

Plans and Documentation

Browse

Organisation Name

Contact name

Position

Email Address

Phone Number

Postal Address

Street address

City

State

Postcode

I have read and agree with the Warrnambool City Council Privacy Policy *

By submitting the Application;

I declare that all the information given is true and correct.
I declare that I have the ability to bind the organisation represented in this Application.
I consent to Warrnambool City Council using the information provided in this Application for assessment of the Application and understand details may be shared with Officers across multiple Departments to fully consider the Application.
The personal information requested on this form is being collected by Warrnambool City Council for the purpose of assessment of the Public Land Manager Consent Request or any other directly related purpose. It will not be disclosed to any other external party without your consent, unless required or authorised by law. If you wish to alter any of the personal information you have supplied to Warrnambool City Council, please contact Council via telephone 5559 4800 or email contact@warrnambool.vic.gov.au