Form Development 09

Application for Construction/Alteration of a Driveway Access

Does this permit/application relate to a Development Application for building work on your land?

Yes

No

If yes, what is the Development Application Number?

E.g 100/2012/458. The application number can be found on your decision notification form

STREET TREES

Does this permit application require the assessment of a street tree in relation to your driveway access?

Yes

No

DETAILS OF PERSON APPLYING FOR THE PERMIT

Property owner first name

Property owner last name

Postal address

Postcode

Phone number

Email address

ADDRESS OF PROPERTY WHERE WORK IS TO BE CARRIED OUT

Street No

Lot No

Street Name

Suburb

DRIVEWAY ACCESS LOCATION

(Plan or diagram required)

To be approved, the following must be provided: (please indicate with a plan or diagram) - Proposed driveway access width, length and location, including distances to the nearest side boundary, trees, side entry pits, service pits and stobie poles - Alternatively, please supply a copy of the building site works plan, with proposed driveway dimensions and location clearly marked on it

Please select which of the following you wish to construct/alter

Please tick which of the following you wish to construct/alter

Driveway Invert and Water table Only

Driveway Crossover Only

Driveway Invert, Water table and Crossover

I intend to construct my crossover in the following materials:

Concrete

Heavy Duty Concret

Paving

FOR PAVING - please specify type and dimensions

QUOTE

I request Council to provide a quotation for this work. (Note: Quotations will only be provided to established houses and new developments at the lock up stage of the build)

APPLICANT:

I hereby apply for a permit to construct/alter a driveway access. I agree to abide by all conditions placed on the driveway access construction and acknowledge that I will be held responsible for any non-compliant works or any damage caused to the council assets during construction. I agree to reconstruct any damage or works that do not comply with the City of Marion’s specifications.

FULL NAME

DATE

ATTACH DOCUMENT