Form
Schedule 1 Form
[r.5]
Office Use Only
Application No. ____________
Form 1
Hope Valley‑Wattleup Redevelopment Act 2000
(Section 26(1))
Hope Valley‑Wattleup Redevelopment Regulations 2000
Application for approval to undertake development
To: The Western Australian Planning Commission
1. Name(s) of Owner(s) in full
Surname (or Company name) . . . . . . . . . . . . . Other names. . . . . . . . .
Surname (or Company name) . . . . . . . . . . . . . Other names . . . . . . . . .
Surname (or Company name) . . . . . . . . . . . . . Other names . . . . . . . . .
2. Address in full . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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3. Applicant’s name in full (if owner put self) . . . . . . . . . . . . . . . . . . . .
4. Address for correspondence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Telephone No. . . . . . . . . . . . . . . .
5. Locality of development (street number, street, suburb)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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6. Description of land: Lot No(s). . . . . Location No . . . .
Plan/Diagram No. . . . . . Certificate of Title Vol. . . . . . Folio . . . . . .
Plan/Diagram No. . . . . . Certificate of Title Vol. . . . . . Folio . . . . . .
7. Name of nearest road junction/intersection . . . . . . . . . . . . . . . . . . .
8. Description of proposed development . . . . . . . . . . . . . . . . . . . . . . . .
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9. Purpose for which land is currently being used . . . . . . . . . . . . . . . .
10. State nature of existing buildings on the land . . . . . . . . . . . . . . . . . .
Are existing buildings to be demolished in whole or in part?
YES/NO (b) WHOLE/PART
11. Materials and colour to be used on external surfaces (including the roof) and any paved areas of the building . . . . . . . . . . . . . . . . . .
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Estimated cost of development $ . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13. Estimated date of completion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Signature of owner(s) of the land. Signature of Applicant(s)
. . . . . . . . . . . . . Date . . . . . . . . . . . . . . . . . . . Date . . . . . .
. . . . . . . . . . . . . Date . . . . . . . . . . . . . . . . . . . Date . . . . . .
. . . . . . . . . . . . . Date . . . . . . . . . . . . . . . . . . . Date . . . . . .
State position if signing on behalf of a Company.
This application is to be accompanied by 6 copies of the plan(s) and specifications for the development and the prescribed fee.
It is an offence under regulation 8 for a person —
to make a statement or give any information which that person knows to be false in a material particular in connection with an application for approval of a development; or
to omit to supply to the Authority any information or particulars which that person knows to be relevant to the application.
The offence is punishable by a fine of up to $1 000.
[Form 1 amended: Gazette 29 Dec 2006 p. 5895.]
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