Appendix D: Form 20
Form 20 Public notice of territorial authority's requirement for designation or alteration of designation
Sections 168A and 181(4), Resource Management Act 1991
[Name of territorial authority] gives notice of its requirement for a designation (or an alteration to a designation) for a public work (or in respect of any land, water, subsoil, or airspace where a restric-tion is necessary for the safe or efficient functioning or operation of a public work).
The site to which the requirement applies is as follows:
[describe the site as it is commonly known and in a way that will enable it to be easily identified (eg, the street address, the legal description, proximity to any well-known landmark, the grid refer-ence (if known))].
The nature of the proposed work is:
[give details].
* The nature of the proposed restrictions that would apply is:
[give details].
* Delete if there are no proposed conditions.
The effects that the public work will have on the environment, and the ways in which any adverse effects will be mitigated, are:
[give details].
Alternative sites, routes, and methods have been considered to the following extent:
[give details].
The public work and designation (or alteration) are reasonably neces-sary for achieving the objectives of the territorial authority because:
[give details].
* The following resource consents are needed for the proposed activ-ity and have (or have not) been applied for:
[give details].
* Delete if no resource consents are needed for the proposed designation.
The following consultation (or No consultation) has been undertaken with parties that are likely to be affected:
[give details].
Form 20 - continued
Please contact [name of person handling queries and contact phone number] if you have any questions about the requirement.
Any person may make a submission on the requirement. You may do so by sending a written submission to [name of territorial authority] at [address and other contact details]. The submission must be in form 21. Copies of this form are available from [name of territorial authority].
Submissions close on [closing date, which must be the 20th working day after this public notice].
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Signature on behalf of
[name of territorial authority]
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Date
