Application for Grant or Renewal of Licence

Application for Grant or Renewal of Licence

Caravan Parks and Camping Grounds Act 1995, sec. 7(1)(a)
1. Facility Details
Facility Name or Proposed Name:
Facility Address:
2. Applicant Details

(Each applicant to provide these details)
Applicant Name(s):
Postal Address:
Phone:
Email:
3. Land Owner(s) Details

(1. Only necessary if different from above, 2. Details to be provided in respect of each landowner)
Land owner name(s)
Postal Address:
Phone:
Email:
4. Documents to be Attached

(Not necessary if application is for renewal of licence)
1. The written approval of the owner of the land referred to in this form for the applicant/s to make this application, or proof that the applicant/s is/are the owner/s of that land.

2. A plan of the proposed facility showing:
1. The sites, and where applicable, denoting the type of sites;
2. The buildings;
3. The roads and paths;
4. The drainage and waste water disposal systems; and
5. The location of fire hoses, fire hydrants and extinguishers.
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5. Declaration
I/We declare that all details in this form are true and correct.
Signature
Date

MonthDayYear

Fees

The following fees apply:

Fee per site, per annum:	Long stay: $6	Short stay and transit: $5
	Camp site: $3	Overflow: $1.50
Minimum fee:	$200
Additional fee for renewal after expiry:	$20

You will be contacted to arrange payment.

1. Facility Details