Adjoining Property Owners Details Application

Adjoining Property Owners Details Application
I, the adjoining owner* or agent** hereby request Council to provide the ownership details of the adjoining property for the following reason.
Please select one*

Dividing Fence - this information is requested to facilitate a fencing matter between my land and the adjoining land owner. It is requested under the Dividing Fences Act 1991. The property owner’s details will NOT be retained, copied or disseminated for unrelated purposes and will be kept secure and only used for advising and serving of fencing matters.Burning off - this information is requested to facilitate the notification of intention to burn off or burn firebreak to adjoining land owners/occupiers. It is requested under the Rural Fires Act 1997. The property owner’s details will NOT be retained, copied or disseminated for unrelated purposes and will be kept secure and only used for the notification of intention to burn off or burn firebreak.Tree - this information is requested to facilitate a tree matter between myself and the adjoining land owner. It is requested in order to satisfy Clause 49 (1)(b) of the Environmental Planning and Assessment (Regulation) Act 2000. The land owners details will NOT be retained, copied or disseminated for unrelated purposes and will be kept secure and only used for adjoining tree matters.Other
*An applicant must provide sufficient evidence of identity and place of residence (proof of ownership).

**An agent will be required to provide proof that they are authorised to act on behalf of the adjoining owner.
Name*

First NameLast Name
Business Name (if applicable
Mailing Address

Street Address

Street Address Line 2

CityState

Postcode
Email*
example@example.com
Phone Number*
Please enter a valid phone number.

Property Information
Property Details*

Street Address

Street Address Line 2

CityState

Postcode
LOT/DP*
Adjoining Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
LOT/DP

Proof of Identity
Australian driver's licence

Cancelof
Current Australian passport

Cancelof
Rates Notice

Cancelof

Proof of Identity - Agent
Letter of Consent from Owner

Cancelof
Power of Attorney

Cancelof
Guardian

Cancelof

Applicant Declaration
Declaration*

I/we confirm that I am/we are the owner/s or agent for the owners of the property detailed and confirm that the adjoining property details requested will only be used for the purpose indicated.
Signature*

Clear
Privacy Notification
(Privacy and Personal Information Protection Act 1998 – Section 10)

- Personal information collected in this application is considered personal or health information for the purposes of the Privacy and Personal Information Protection Act 1998 (PPIPA). Information provided will only be used for the purpose for which it is collected. The intended recipients of the personal information are Council officers and may extend to any person wishing to inspect the application in accordance with the Local Government Act 1993 or the Government Information (Public Access) Act 2009. The supply of this information is voluntary, however if you do not wish to provide all details requested, Council may be unable or limited in dealing with your request. You may make application to access, amend or suppress your personal information which Council will consider in accordance with the PPIPA.
Please verify that you are human*
Should be Empty: