Works Over Approval Application Form (Page 2 of 2) in pdf

Section 4: Building Consent Details

Have you applied for/obtained building consent?

Yes : Building consent no.

Date

Name of the building consent processor (if known)

Please note: This application will not be processed if incomplete or it is missing any of the documents outlined in the Section 6: Checklist.

Section 5: CCTV Inspection Details

Please provide the details of the contractor undertaking the CCTV inspection below.

First name

Last name

Company name (if applicable)

Postal address

So that we can get back to the contractor quickly email is

the best and most efficient method for correspondence.

Phone (

)

Mobile (

)

Fax (

)

Section 6: Checklist

1. Missing information will delay processing of this application. Providing all of the documents outlined below is the best way to ensure

timely processing of your application.

A site plan showing your proposed development in relation to our

A plan showing details of your proposed building foundations

water and wastewater assets.

in relation to our water and wastewater assets.

A pre-construction CCTV inspection video and report showing the

A plan showing how you intend to protect our assets. The bridging plan

must show the vertical and horizontal clearances of your structure from

condition of the public wastewater pipe.

any water and wastewater pipes and manholes.

2. Full payment of the Watercare Services Limited invoice is

The correct legal property address of the site (as allocated by

Auckland Council).

required prior to approval being issued.

Section 7: Authorisation

I, the undersigned, hereby declare that the information given on this application is true and correct. I authorise Watercare Services Limited to invoice me

with all applicable charges for the services indicated and accept the terms and conditions of the Customer Contract with Watercare Services Limited.

Name

Signature

Date

Privacy

The information supplied in this application form will be held and used by the staff of Watercare Services Limited. The information will not be disclosed

by Watercare Services Limited unless legally required under the Local Government Official Information and Meetings Act 1987 or for one of the purposes

in connection with its collection. The information supplied will be used for: assessing and processing this application and for administration purposes,

updating Watercare Services Limited’s records to ensure all records are accurate, providing Watercare Services Limited with statistical information to

assist policy development. You have the right to request access to and correction of information collected.

For office use only

Application number

Lodgement date

(09) 442 2222