Applicant Details

Applicant name

Business trading name

Email address *

Postal address *

Preferred phone number *

Secondary phone number

Owners Details (if not the applicant)

Name

Business trading name (if applicable)

Postal address

Description of the Land

Street number

Street name

Town

Post code

AND/OR

Lot number

Plan number

Other Legal DescriptionOther legal description may be a Crown Allotment reference, Volume/Folio, or other title descriptor.

If the proposal relates to multiple addresses/parcels, please attach a document with a list of the owner and land description details for each additional property.

Additional land details

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If the proposal relates to multiple addresses/parcels, please attach a document with a list of the owners and land description details for each additional property.

Declaration in relation to Title Restrictions

Is there any encumbrance on the Title such as a restrictive covenant, section 173 agreement or other obligation such as an easement or building envelope? *

YesNo

Will the proposal result in a breach of a registered covenant restriction or agreement? *

Yes No

Description of proposal

Provide a brief description of your proposal *

Under which section of the Act is the amendment to the application made? *

s50 Amendment by applicant before notices57A Amendment by applicant after notice is given

One answer only

Matters for which a permit is required

Refer to Council’s Guide Matters for which a Permit is Required (Word .docx) available through our website.

How many matters are required for this proposal?

Planning Scheme Clause Choose from the list

Matter for which the permit is requiredCopy from the Matters for which a permit is required document, removing variables and inserting uses as required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Planning Scheme Clause

Matter for which the permit is required

Revised estimated cost of development *Note: You may be required to verify this estimate

Existing conditions

Describe how the land is currently used and developed *

Application Requirements

Required supporting documents (if the amendment to the application affects the existing documents):

Title to each property subject to the application (must have been generated within the past 30 days)
Full copy of Covenants or Section 173 agreements if applicable, and details of beneficiaries if there is a proposal which would contravene, alter, or end a covenant or restriction.
Supporting documents which are mandatory requirements of the Planning Scheme (e.g. – Native Vegetation Removal Report, Bushfire Management Statement, Geotechnical report/waiver)
Plans as relevant to the proposal

Suggested, or subject to requirements of the scheme

A report responding to the relevant application requirements and the policies and objectives of the East Gippsland Planning Scheme
Supporting information/reports which are commonly considered with similar applications (e.g. – Land Capability Assessment, Bushfire Management Statement, Geotechnical report/waiver)

Attach forms

Full copy of Title

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Must have been generated within the past 30 days. Use the additional attachment dialogue for multiple files

Copy of covenant(s) or s173 Agreement(s) on Title (if applicable)

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Relevant Plans

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Plans as relevant to the proposal. Seek advice if unsure.

Planning report

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How many additional files do you need to upload?If greater than 20, consider combining attachments or email further attachments to planning@egipps.vic.gov.au

Supporting information/reports

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Payment of Application Fees

For a s50 application, no additional fees are payable unless the amendment introduces a matter not already covered by the original application.

For a s57A application, a fee of 40 percent of the original application fee amount is payable. The amount will be to be confirmed by a senior planning officer in accordance with the Planning and Environment (Fees) Regulations 2016. An invoice will be generated once the amended application has been assessed to confirm it is complete.

Who is the invoice to be made out to? (Payer)

Address for Invoice

Invoice Email

Preferred Phone Number

Secondary Phone Number

Privacy Statement

The East Gippsland Shire Council asks for details about you to make decisions on planning permit applications. The information you give to us on this form is used for your application and is required for Council to make its decision under the Planning and Environment Act 1987. Sometimes we may provide a copy of this application form to another person, but only if it is for a legitimate purpose that is related to the planning process, or we are allowed by law, or to protect people or property. If your information is put onto Council's website or provided to another person, Council will always try to make sure your privacy is protected in line with the Privacy and Data Protection Act 2014. For instance, if requested by another person, after deciding that it is requested for a legitimate purpose, Council will obtain an undertaking from the recipient confirming how they will use your personal information and that they will destroy it once used.

You may ask for more information about Council's Privacy Policy by contacting our Privacy Officer on 03 5153 9500 or e-mail feedback@egipps.vic.gov.au .You can gain access to information you provided to us through the Freedom of Information Act 1982, more information about FOI is available on Council's website.

Declarations

Please complete this section to confirm your application.

I declare that I am the applicant and all the information in this application is true and correct and the owner (if not myself) has (have) been notified of the permit application. *

I confirm I have authority to use the relevant documents.
*

In the event that the giving of notice is required pursuant to Section 52 Planning and Environment Act 1987, I permit documents submitted as part of this application, including my full contact information, to be made available for public viewing on Council's website. *

In the event that the giving of notice is required pursuant to Section 52 of the Planning and Environment Act 1987, and I receive instructions to give notice to potentially affected parties, I confirm that I will destroy the instructions and personal information once the information is no longer necessary.

*

I accept the East Gippsland Shire Council Privacy Statement. *

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