Subdivision Works Construction Certificate Application

Subdivision Works Construction Certificate Application

Made under Part 4A of the Environmental Planning and Assessment Act 1979

Application form updated September 2018

Please email completed form and accompanying information (Section 6 of this form) to council@thehills.nsw.gov.au Please contact us on 9843 0374 if you need help competing this form.

1. TYPE OF APPROVAL BEING SOUGHT

Please complete Construction Certificate

Construction Certificate (Minor Works)

Public Road Works (Section 138 of the Roads Act 1993)

Other Public Works (Section 68 of the Local Government Act 1993) Compliance Certificate

Appointment of Council as Principal Certifying Authority (PCA)

2. APPLICANT

Applicant must complete the Applicant Declaration in Section 8 of this form

Family Name or Company Name Given Name or ACN

Address

Suburb Postcode

Email Phone

Contact Name

If the applicant is a Company, please nominate a Contact Person who can be contacted during business hours to discuss this application

3. OWNER'S CONSENT

Refer to Applicant Declaration in Section 8 of this form

Owner Address

Suburb Postcode

4. PROPERTY DETAILS

This is the location of the development site

Address Suburb

Lot(s) DP(s)

5. DEVELOPMENT DETAILS

Description of Proposal

Development Consent No. Date of Consent:

Has consent been modified? No Yes

Modification details Estimated Cost of Work

6. LODGEMENT CHECKLIST

Your application will be processed faster if you provide all necessary and correct information.

Please complete

Yes No N/A

Detailed engineering design/construction plans and specifications Any compliance certificates to be relied on have been provided

Reference to Council's specifications has been made in General Notes on the plan Statement certifying the plans have been endorsed by a Chartered Professional Engineer Details of consultation with public authorities concerning the provision of utility services Undergrounding of existing overhead services acknowledged on plan

All required State/Public Authority approvals have been obtained and copy has been provided Erosion & Sediment Control Plan (small sites) or Soil & Water Management Plan (large sites) Site Specific Dust Management Plan

Traffic Control Plan

Construction Management Plan Dilapidation Report

Pavement Design

Landscaping plan including street tree details that are consistent with Master Plan All necessary security bonds (as required by the consent) have been lodged Long Service Levy has been paid and evidence of payment has been provided

All consent conditions, as required prior to the issue of a construction certificate, have been satisfied Professional Indemnity Insurance for a minimum $5 million for all consultants involved in the project Public Liability Insurance for a minimum $10 million and full Workers Compensation Insurance as required by NSW law for all contractors involved in this project

All matters identified in Construction Certificate pre-check have been addressed

7. APPOINTMENT OF PRINCIPAL CERTIFYING AUTHORITY (PCA)

Please complete I appoint The Hills Shire Council as The Principal Certifying Authority (PCA) for this project

Notes regarding PCA:

1. In accordance with Section 81A(4) of the Environmental Planning and Assessment Act 1979 subdivision work cannot commence until the person having the benefit of the development consent has appointed a Principal Certifying Authority for the subdivision work.

2. For subdivision work, Council must be the Principal Certifying Authority as per Section 109D of the Environmental Planning and Assessment Act 1979. To assist, this application form incorporates an appointment of Principal

Certifying Authority form.

3. A schedule of required inspections, hold points and notification requirements is provided in The Hills Shire Council’s Works Specifications – Subdivision and Developments and must be followed. These inspections must be carried out by Council’s Construction Engineer.

8. APPLICANT DECLARATION

Please complete I certify that all conditions required by the development consent, as required prior to the issue of a Subdivision Certificate have been complied with. Alternatively, I have reached agreement in terms of security and time frames as to when any outstanding conditions will be complied with.

I certify that I have obtained the consent of all owners of the land to which this application relates and that I am acting in accordance with the consent of all owners.

I understand that incomplete or deficient applications will be rejected.

Declaration I acknowledge this declaration is confirmation of my identity and intent in lieu of my signature.

Full Name Date

8. PRIVACY AND PERSONAL PROTECTION NOTICE

Purpose of Collection For delivery of subdivision & certification services in The Hills Local Government area Intended Recipients The Hills Shire Council staff

Supply If you choose not to supply your personal information, we may not be able to supply the services you seek

Storage The Hills Shire Council, 3 Columbia Court, Norwest NSW 2153