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Flood Control Lot Certificate Application / Roads and Stormwater Unit / Jan-23 Page 1 of 2
Flood Control Lot Certificate Application
(OFFICE USE)
Application No File No Date Received
DA No Land No Property No
A1. Applicant
Surname/s Given
Name/s OR
Company/
Organisation ABN
Postal Address
Telephone Mobile
A2. Land Description
Lot No Section DP/NPP/SP
Unit/Street No Street
Suburb/Town
NOTE: A separate application form and applicable fee is required for each allotment to be certified
A3. Certification Details
Application is hereby made for a Flood Control Lot Certificate, in accordance with:
• State Environmental Planning Policy (Exempt and Complying Development Codes) 2008, under the Environmental Planning and Assessment Act 1979
• Part 3 Housing Code
Division 2 General standards relating to land type Clause 3.5 Complying development on flood control lots
• Part 3A Rural Housing Code
Subdivision 9 Development standards for particular land Clause 3A.38 Development standards for flood control lots
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Flood Control Lot Certificate Application
Roads and Stormwater Unit
Page 2 of 2 Flood Control Lot Certificate Application / Roads and Stormwater Unit / Jan-23
A4. Attachments (select one option)
Two (2) copies of a site plan, showing the part of the lot requested to be certified. This must include the development footprint for all development that will be subject to a Complying Development Certificate application.
Nil - request certification of the entire lot.
NOTE: If no site plan is attached, the certificate shall apply to the entire lot, based on the highest case flood risk or hazard that applies to any part of the lot.
A5. Applicant's Declaration
I declare that all the information in this application is true and correct.
I understand that if the information is incomplete the application may be delayed or rejected.
Applicant's Name (please print)
Applicant's Signature Date