To: The Registrar
[Environment Court]
Wellington
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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. 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.