Pipelines Regulations 2017

Regulation 15

Pipelines Act 2005

Pipelines Regulations 2017

To: Minister administering the Pipelines Act 2005

I, [insert name of licensee including Australian Business Number], apply under section 73 of the Pipelines Act 2005 for the amendment of Pipeline Licence number [insert Pipeline Licence number] (the ongoing licence) to consolidate it with the whole or part of the following Pipeline Licence number/s [insert Pipeline Licence numbers] and submit the following particulars:

The pipelines are described as follows:

[insert a brief description of the use of each pipeline and of each pipeline route]

A copy of a map showing each pipeline route is attached to this application.

The reasons for this application to consolidate pipeline licences are: [insert reasons for the application]

Address of the applicant or registered business address if the applicant is a company:

Postal address of the applicant:

Telephone number of the applicant:

Fax number of the applicant:

Email address of the applicant:

*An additional length of authorised route of the pipeline is required.

[Provide details of additional length]

[Insert any other amendments of the licence required for the purposes of consolidation]

Signature of the licensee:

Date:

*Delete if inapplicable