CAPRICORN MUNICIPAL DEVELOPMENT GUIDELINES
Local Government ....................................................................
(INSERT LOCAL GOVERNEMNT NAM NAME)
ANNEXURE AP1.A
STATEMENT OF COMPLIANCE
ENGINEERING DESIGN
This form duly completed and signed by an authorised agent of the Consulting Engineer shall be
submitted with the Engineering Drawings for Council Approval.
Name of Development
................................................................................................................
Location of Development
................................................................................................................
Applicant
................................................................................................................
Consulting Engineer
................................................................................................................
It is hereby certified that the Engineering Drawings submitted herewith have been prepared,
checked and amended in accordance with the requirements of the Capricorn Municipal
Development Guidelines and that the competed works comply with the requirements therein, except
as noted below.
Compliance with the requirements of the
Capricorn Municipal Development
Guidelines - Engineering Design and
Construction
Plan Presentation
Geometric Road Design
Pavements
Structures / Bridges
Subsurface Drainage
Stormwater Drainage
Site Re-grading
Erosion Control and Stormwater Management
Cycleway / Pathways
Bushfire Protection
Water Reticulation
Electrical Reticulation and Street Lighting
Associated Documentation/ Specification
Compliance
Yes/No
Non-Compliance refer to noncompliance report drawing
number
Conscientiously believing the above statements to be true and correct, signed on behalf of:
Consulting Engineer
................................................................. RPEQ No .............................
Name in Full
................................................................................................................
Signature
................................................................. Date .....................................
CAPRICORN MUNICIPAL DEVELOPMENT GUIDELINES
www.cmdg.com.au
Page 1 of 1
ISSUE NO: 1 – October2007