Resource Consent Application for resource consent Form 9, Resource Management Act 1991 All sections of this form must be completed before your application can be assessed. Information required to accompany this form is specified in the attached checklist. We recommend that you talk to one of Council s resource consent planners about your application before you fill in this form. Council s duty planner can be contacted on 07 3760899 or email at dutyplanner@taupo.govt.nz 1. Contact and Invoicing Details Applicant name (in full): Postal address: Landline: Mobile: Email address: This is the person that invoices will be sent to. For individuals you must provide the full names of all individuals. For companies and other incorporated entities you must provide the company name and registration number. You must also provide the name of a person or persons who will represent your company and be responsible for the application. For partnerships and unincorporated entities (such as private or family trusts or unincorporated societies) we must have the details of all authorised partners, trustees, members or officers. We may also request a copy of your society s rules to verify your status as a formal body or society. Agent name (if applicable): Postal address: Landline: Email address: Mobile: Address for service: Agent Applicant Would you like to receive correspondence via emails? No Do you agree to have your application and related documents provided displayed on Council s website? No In providing your consent you are acknowledging to Council that you own all applicable rights to the materials which form part of your application. 2. Application Type(s) Landuse Consent Subdivision Consent Certificate of Compliance Variation/Cancellation of Consent Conditions Outline Plan Waiver Other (please detail): Variation/Cancellation of Consent Notice Existing Use Rights Certificate NES for Assessing Contaminants in Soil to Protect Human Health (e.g. change of land use or subdivision) 3. Description of the Activity or Works Proposed Describe your proposal giving as much information as possible. Detail the Taupo District Plan rules or standards your proposal does not comply with. By providing an accurate description of the proposal you will avoid unnecessary delays in processing your consent. Page 1
4. Site Details You will need to provide a current (less than three months old) certificate of title along with copies of any consent notices on your title. Council can provide these documents for a fee. These fees will be added to your consent processing fee if you tick yes to Council providing these documents in the box below. Street address: Legal description: Lot no: DP: Certificate of Title no: Tick one of the following: A current certificate of title and copies of all consent notices on the title are attached. I authorise Council to obtain copies of the certificate of title and any consent notices on the title and to add the relevant charges to my consent processing fee. 5. Details of Site Owner/Occupier(s) Owner/Occupier name (in full): Address: Owner/Occupier name (in full): Address: Owner/Occupier name (in full): Address: 6. Other Activities Describe any other activities that are part of the proposal to which the application relates: 7. National Environment Standard (NES) This section relates to the National Environmental Standard (NES) for Assessing and Managing Contaminants in Soil to Protect Human Health. The NES includes regulations controlling soil disturbance, change of use, subdivision and removal/replacement of fuel storage systems on properties which have been used either now or in the past for a hazardous activity or industry (known as HAIL) that may have resulted in contamination of the soil. Please answer the following questions to determine whether the NES applies to your proposal. Is the activity described on the Hazardous Substances and Industries List (HAIL) currently being undertaken on the piece of land to which this application relates, or is it more likely than not to have ever been undertaken on the land? The HAIL list is available at: www.mfe.govt.nz/laws/standards/contaminants-in-soil No Type of HAIL activity: If the answer to the above question is YES, then the NES may apply, depending on the proposed activity. Please identify whether the application involves any of the activities below. If the answer to the above question is NO, then you do not need to answer the remaining questions in this section. Will the proposed activity involve disturbance of more than 25m 3 of soil (per 500m 2 )? No Volume of soil disturbance: Will the proposed activity involve removal of more than 5m 3 of soil (per 500m 2 ) from the site? No Volume of soil removal: Does the application involve changing the use of the land to one which, because the land has been subject to a HAIL activity, is reasonably likely to harm human health? (e.g., service station to office, orchard to residential). No Page 2
Does the application involve removing or replacing a fuel storage system or parts of it? No Does the application involve subdivision of the land? No If the answer to any of the above activity questions is also YES, then the NES will apply. Soil disturbance or removal exceeding the specified volumes requires consent. Changing the land use or subdivision of the land will require resource consent if the permitted activity requirements of the NES are not complied with. These include provision of a Preliminary Site Investigation carried out by a suitably qualified and experienced practitioner. Removal or replacement of a fuel storage system will require consent if the permitted activity requirements of the NES are not complied with. Does the proposed activity require resource consent under NES? If YES, an assessment of the application under the NES must be provided as part of your Assessment of Environmental Effects. A Detailed Site Investigation may be required. 8. Other Applications Have you applied for, or are you required to apply for, any other resource consents for this project, and if so, what type? No Regional Council Consents Water Permit Discharge Permit Coastal Permit Has been applied for: Is required to be applied for: Has been obtained: Reference no. (if applicable) OR No additional resource consents are needed for the proposed activity. Have you applied for a Project Information Memorandum (PIM) or a Building Consent for this project? No If yes, what is the project number? BC 9. Approval of Affected Persons All property owners, including trustees where properties are held in a trust, must sign written approval forms AND a copy of your plans. Council s duty planner can help you to identify all property owners. If an affected person does not give approval to your proposal this may impact on the way that the application is processed. Council s duty planner can provide you with advice on who may be affected by your proposal. Have you attached signed written approval forms and plans? No 10. Pre-application Information Have you had a pre-application meeting with the council regarding this proposal? No Copy of minutes attached Date of meeting: If yes, provide the name(s) of the staff member(s) met with: 11. Site Visit Requirements Is there a locked gate or security system restricting access by Council staff? No Is there a dog on the property? No If yes, how many dogs? Provide details of any entry restrictions or hazards that Council staff should be aware of e.g. health and safety, organic farm etc.) Page 3
12. Signature and Important Information for the Applicant A fee is payable on lodgement of all applications and must be paid before processing of the application will start. The fees are set out in the Schedule of Fees and Charges on Council s website. If the application is withdrawn by the applicant the processing costs incurred by Council up to the date of withdrawal will be deducted from the deposit fee paid and balance will be refunded. A further invoice will be sent to the applicant when the processing of this application has been completed if the cost of processing exceeds the deposit paid. Applicants will also be liable for debt recovery costs in the event that processing fees are not paid. A development contribution (DC) may also be payable. Council s duty planner can give you more information on whether your application may require the payment of a DC. If resource consent is granted the consent holder has a legal obligation to comply with any condition of the consent. Consent conditions will be monitored. Monitoring may incur additional fees which will be charged to the consent holder. The information you provide with your application is official information. It is used to help process your resource consent application and assess the impact of your activity on the environment and other people. The information is held and administered by the Taupo District Council in accordance the Local Government Official Information and Meetings Act 1987 and the Privacy Act 1993. This means that your information may be disclosed to other people you request it in accordance with the terms of these Acts. It is therefore important you let us know if your application includes trace secrets, commercially sensitive material or any other information you consider should not be disclosed. Under the Privacy Act 1993 you have right of access to personal information held by Taupo District Council. By signing this form, if you are the owner of the application site, you confirm that the Council may undertake a site inspection. I hereby certify that I have read and understood the above information and that, to the best of my knowledge and belief, the information given in this application is true and correct. I undertake to pay all costs relating to this application incurred by the Taupo District Council. Signature: Date: Page 4
Resource Consent Information Checklist The following information must accompany your application. Please tick below to confirm that you have provided the required information. Your application will not be accepted for processing until this information has been provided. Other information such as expert landscape, traffic or economic reports may be required for some proposals. Council s duty planner will be able to provide advice on whether such reports will be required. Please attach any other information that you feel may help Council in assessing your proposal, for example, photographs. Completed application form Have you filled in every section of this form? Is it signed? Certificate of Title & and Consent Notices See notes in Section 4 of the application form Application fee Amount paid $ An Assessment of Environmental Effects Must include reference to the following: If it is likely that the activity will result in any significant adverse effect on the environment, a description of any possible alternative locations or methods for undertaking the activity. N/A An assessment of the actual or potential effect on the environment of the activity. If the activity includes the use of hazardous substances and installations, an assessment of any risks to the environment that are likely to arise form such use. If the activity includes the discharge of any contaminant, a description of the nature of the discharge and the sensitivity of the receiving environment to adverse effects and any possible alternative methods of discharge, including discharge into any other receiving environment. A description of mitigation measures (including safeguards and contingency plans where relevant) to be undertaken to help prevent or reduce the actual or potential effect. Identification of the persons affected by the activity, any consultation undertaken, and any response to the views of any person consulted. If the scale and significance of the activity s effects are such that monitoring is required, a description of how and by whom the effects will be monitored if the activity is approved. If the activity will, or is likely to, have adverse effects that are more than minor on the exercise of a protected customary right, a description of possible alternative locations or methods for the exercise of the activity (unless written approval for the activity is given by the protected customary rights group). Any effect on those in the neighbourhood and, where relevant, the wider community, including any social, economic, or cultural effects. Any physical effect on the locality, including any landscape and visual effects. Any effect on ecosystems, including effects on plants or animals and any physical disturbance of habitats in the vicinity. Page 5
Any effect on natural and physical resources having aesthetic, recreational, scientific, historical, spiritual, or cultural value, or other special value, for present or future generations. Any discharge of contaminants into the environment, including any unreasonable emission of noise, and options for the treatment and disposal of contaminants. Any risk to the neighbourhood, the wider community, or the environment through natural hazards of the use of hazardous substances or hazardous installations. Other Information Required Assessment of the activity against the matters set out in Part 2 of the Resource Management Act 1991 - http://www.legislation.govt.nz/ Assessment of the activity against the following provisions Any relevant objectives, policies, or rules in a document. Any relevant requirements, conditions, or permissions in any rules in a document. Any other relevant requirements in a document (e.g. in a national environmental standard or other regulations). Site Plan - Ensure that the site plan is to scale and that it shows: Road name and street number Legal description North point Scale All existing and proposed buildings Site coverage calculations Vehicle crossings and driveways Vehicle parking and manoeuvring areas (NB two vehicle parking spaces, which can include internal garage parks, are required for dwellings over 80m 2 The position of any proposed signage Floor plans for any proposed building(s) Include all parts of the building, including basements, parking, lifts, mezzanines, storage and service areas Elevations plans for any proposed building(s) - Ensure that the elevations plan is to scale and that it shows: The natural ground level, shown to the site boundaries Existing and finished ground levels Maximum building height and relevant height plane angle(s) External appearance of the building The depth of cut/fill for any proposed earthworks Affected party approvals Have all owner(s) and occupier(s) of each property signed both the approval form and the plans? SUBDIVISION CONSENTS ONLY Additional information required for Subdivision consents Must include the following additional information: The position of all new boundaries. Areas of all new allotments, unless the subdivision involves a cross lease, company lease, or unit plan. Page 6
The locations and areas of new reserves to be created, including any esplanade reserves and esplanade strips. The locations and areas of any existing esplanade reserves, esplanade strips, and access strips. The locations and areas of any part of the bed of a river or lake to be vested in a territorial authority under section 237A of the Resource Management Act 1991 - http://www.legislation.govt.nz/ The locations and areas of any land within the coastal marine area (which is to become part of the common marine and coastal area under section 237A) of the Resource Management Act 1991 - http://www.legislation.govt.nz/ The locations and areas of land to be set aside as new roads. Subdivision plan (if applicable) - Ensure that the subdivision plan is to scale and that it shows: Allotment boundaries and areas All existing and proposed buildings Site coverage calculations The position of all utility services (public & private) Position of any easements and other restrictions over the allotment Vehicle parking, access, manoeuvring and loading areas Proposed retaining walls, excavations, filling of the land and resultant contours Existing ground level and contours Existing and proposed landscaping Lodging your application: Your application can be lodged online at www.taupo.govt.nz/resourceconsentapplications Select the Apply for your consent online link, register to create an account and select the resource consent application in the Services tab. Or mailed to: Taupō District Council Private Bag 2005 Taupō Mail Centre Taupō 3351 Or dropped into any of the following offices: Taupō Office Turangi Office Mangakino Office 72 Lake Terrace Town Centre Civic Centre Taupō Turangi Rangatira Drive Mangakino Page 7