Application to keep bees in an urban area

Applicant details
Management Agency Registration number*
Name (individual or company)*

First nameLast name
Postal address*

Street address

Street address line 2

CityRegion

Postal code
Phone number*

Area codePhone number
Mobile number*

Area codePhone number
Email*
example@example.com
Hive location
Proposed number of hives*
Maximum number of occupied hives per urban lot limited to 3.
Location of Hive(s): (provide site plan)*

Cancelof
Hive location address*

Street address

Street address line 2

CityRegion

Postal code
Property owner details
Property owner name*

First nameLast name
Phone number*

Area codePhone number
Mobile number

Area codePhone number
Email*
example@example.com
Is the property owner being paid to have beehives on their property?*

YesNo
Please provide details of payment.
Supporting documents

Agreement from neighbour(s) and inspection report
Agreement from neighbour(s)

You must provide written advice of support from occupiers of any adjoining residential proeprty. Support from every neighbour will help your application be considered more quickly.

Upload a copy (this can be a screenshot) of the agreement from all affected neighbour(s). Agreement must include:
- name and address of applicant
- name and address of neighbour
- what the neighbour understands they are giving their agreement to.
Agreement from neighbour(s) upload*

Cancelof
Inspection report
Inspection report from an approved contractor upload*

Cancelof
Declaration
By typing my name in the box below, I certify that:
- I am the applicant named above.
- I give Council permission to hold this personal information about me in accordance with the Privacy Act 2020 for the purposes of assessing my application under the Keeping of Animals, Bees and Poultry Bylaw.
- I have advised any neighbour(s) listed that their personal information including their name, contact number and address will be included in the application form to be provided by Council and managed in accordance with the Privacy Act 2020.
- I confirm that the information on this form is true and correct to the best of my knowledge and belief.
- I confirm I have read, and agree to the terms and conditions of the granting of any licence.
Name*

First nameLast name
Date*

MonthDayYear
Date
Should be Empty:

Applicant details

Hive location

Property owner details

Supporting documents

Agreement from neighbour(s)

Inspection report

Declaration