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Appendix 7

Reference to [Environment Court] under clause 14 of the first schedule to the Resource Management Act 1991

To: The Registrar
[Environment Court]
Wellington

  1. Name of applicant, along with a statement that this person made a submission or is the relevant territorial authority:
  2. Name of authority issuing the proposed policy or plan or making a decision on submissions or Name of requiring authority or heritage protection authority which made the decision:
  3. Date of receipt or public notification of the decision [whichever is later]:
  4. Description of the subject matter of the proposal or decision [ie type of proposed policy or plan] and specific provision, omission, or part of decision on submissions being referred or Description of the relevant decision of the requiring authority or heritage protection authority.
  5. Reason for reference: [State in summary the reasons for the reference. Clearly indicate whether you support or oppose the specific provisions or wish to have amendments made, giving reasons]
  6. Relief sought:

....................................................................
[Signature of applicant or person authorised to sign on behalf of applicant]

....................................................................
[Date]

Address for service of applicant:

....................................................................

....................................................................

Telephone No: ....................................................................

Fax No: ....................................................................

Annexures:

a. Copy of submission to which reference relates, if applicable:

b. Copy of proposed policy or plan or relevant part thereof or copy of decision on submissions or relevant part thereof or copy of response of requiring authority or heritage protection authority:

c. Any other documents necessary for an adequate understanding of the reference:

d. Names and address of person to be served with a copy of this notice.