Application to Reside in Temporary Accommodation on Private Property

Application to Reside in Temporary Accommodation on Private Property
Purpose

This application form is for people seeking approval to reside in temporary accommodation, such as a caravan or tiny home, on land that they own or lawfully occupy (for example, as a tenant). Approval may be granted by the Shire of Nannup, subject to the relevant legislative requirements and the Shire's policies and procedures.

The Shire of Nannup reserves the right to revoke an approval if complaints are received that, in the opinion of the Shire, unreasonably affect the amenity of neighbouring properties, or on any other grounds considered necessary to protect public health, safety and wellbeing.
1. Applicants Details
Name:

First NameLast Name
Address:
Phone:
Email:
2. Property Owner's Details and Consent

(if different from above)
Name:

First NameLast Name
Phone:
Email:
I/we blanks being the property owner(s) of blank (address of property subject to application) indicate our support for the applicant above to reside in temporary accommodation on this property as approved by the Shire of Nannup.
Signature
Date:

MonthDayYear
Date
3. Temporary Accommodation Details
Property Address:
Number of People Temporarily Residing:
Type of Temporary Accommodation:
Description of Temporary Accommodation (number, type, vehicle rego details, location etc):
Type of Wastewater Disposal System:
Source of Potable Water Onsite:
Capacity of tank:
Description of Electrical Supply:
4. Required Supporting Documentation

(for new applicants only)
Please provide a sketch plan of the property showing where:
Sketch Plan Upload

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5. Declaration
I declare that the information provided in this application is true correct. I also acknowledge that the temporary accommodation has not been designed or constructed to withstand a bushfire and is not considered to be defendable.

I understand that, should a bushfire threaten the property, the Shire of Nannup recommends that all occupants evacuate at the earliest opportunity.
Name:

First NameLast Name
Signature
Date

MonthDayYear
Date
Fees

The following fee applies: $130

You will be contacted to arrange paymnet.
Should be Empty:

Application to Reside in Temporary Accommodation on Private Property

1. Applicants Details

2. Property Owner's Details and Consent

3. Temporary Accommodation Details

4. Required Supporting Documentation

5. Declaration