Appendix 4
Application for resource consent under section 88 of the Resource Management Act 1991
To (Name of local authority)
Submission on (Name of proposed policy statement or plan)
I, [Full name and address of applicant] apply for the resource consent(s) described below:
1. The names and addresses of the owner and occupier (other than the applicant) of any land to which the application relates are as follows:
2. The location to which this application relates is:
(Describe the location in a manner which will allow it to be readily identified, eg the street is:)
3. The following additional resource consents are required in relation to this proposal and have or have not been applied for:
4. I attach an assessment of any effects that the proposed activity may have on the environment in accordance with section 88 of, and the Fourth Schedule to, the Act.
5. I attach other information (if any) required to be included in the application by the district or regional plan or regulations.
6. (Where the application is for a subdivision consent) I attach information in accordance with section 219 of the Act sufficient to adequately define:
a. The position of all new boundaries;
b. The areas of all new allotments (not required for cross-leases, company leases, or unit plans);
c. The location and areas of new reserves to be created, including any esplanade reserves to be set aside on a survey plan under section 230 of the Act;
d. The location and areas of any esplanade strips to be created under section 232 of the Act;
e. The location and areas of any existing esplanade reserves, esplanade strips, or access strips;
f. The location and areas of land below mean high water springs of the sea or of any part of the bed of a river or lake which is to be vested in the Crown or local authority under section 237A of the Act;
g. The location and areas of land to be set aside as new road.
7. (Where the application is for a consent for reclamation) I attach information in accordance with section 88(7) of the Act to show the area proposed to be reclaimed, including its size and location, and the portion of that area (if any) to be set apart as an esplanade reserve.
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(Signature of applicant or person authorised to sign on behalf of applicant)
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(Date)
Address for service of applicant:
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Telephone No: ....................................................................
Fax No: ....................................................................
Annexures:
a. An assessment of effects on the environment in accordance with the Fourth Schedule to the Act:
b. Any other information required by the district plan or regional plan or Act or regulations to be included:
c. (For subdivision consents only) Other information in accordance with section 219 of the Act:
d. (For consents for reclamation only) Other information in accordance with section 88(7) of the Act.
