Application to Council for approval to vary the Building
Regulations under part 4 of the Building Regulations 2006
To: Nillumbik Shire Council
Re: (subject address):
I, hereby seek the consent and report of Council, in accordance with Schedule 2 of
the Building Act 1993.
Name (owner/agent of owner/relevant building surveyor)
Postal Address:
Telephone:
E-mail:
Signature:
Date:
(If you are applying as an agent of the owner, by signing this application form you
acknowledge that you have the consent from the owner in writing)
Accompanying this application is:

Description of proposal and justification of compliance with the Minister’s decision
guidelines. See the Victorian Building Authority website

Two copies of plans of the subject allotment, adjoining properties and where
relevant, the location of habitable room windows, private open space, secluded
private open space, relevant elevations and sections appropriately dimensioned,
any significant vegetation on the site and on adjoining sites.

A full copy of a current Certificate of Title of the allotment, including lot plan,
covenants and agreements as listed on title

The written comments are required on the proposal from the owners of all nearby
allotments that could be affected by the proposal. (These comments and
signatures are to be on one of the plans submitted and must show that the
nearby owners have a full understanding of the application for the variation being
sought).

Fee of $250.60 (cheques made payable to Nillumbik Shire Council)

Any other information that would support the application.
July 2015
Please circle appropriate regulation and complete the
relevant requirements
Regulation 408 - Required setback
Proposed setback (m)
Required setback (m)
Regulation 409 - Minimum street setback
Proposed setback (m)
Required setback (m)
Regulation 410 - Maximum building height
Proposed building height (m)
Maximum height (m)
Regulation 411 - Site Coverage
Existing site coverage (m)
Proposed site coverage (m)
Regulation 412 - Permeability
Existing impermeable surface area
(m2)
Proposed impermeable surface area
(m2)
Regulation 413 - Carparking
Proposed carparking dimension of
each car park (m)
Regulation 414 - Side and rear boundary setback
Existing setback (m)
Proposed building setback (m)
Proposed wall height (m)
Regulation 415 - Walls or Carport within 1m of boundary
July 2015
Existing wall height (m)
Proposed wall height (m)
Existing building length (m)
Proposed building length (m)
Existing setback (m)
Proposed setback (m)
Regulation 416 - Daylight to existing habitable room windows
Adjoining building floor level at
window (m)
Adjoining building roof boundary
setback (m)
Proposed wall or carport height (m)
Proposed building roof boundary
setback (m)
Regulation 417 - Solar access to existing north facing habitable room window
Existing adjoining building boundary
setback (m)
Proposed building boundary setback
(m)
Proposed building wall or carport
height (measured from natural ground
level to roof) (m)
Regulation 418 - Overshadowing to recreational private open space
Regulation 419 - Overlooking in adjoining allotments
Regulation 420 - Daylight to new habitable room windows
Regulation 421 - Private open space
Proposed private open space area
(m)
Existing private open space area (m)
Regulation 422 - Siting of class 10a
Regulation 424 - Front fence height
Regulation 425 - Fences setbacks from side and rear boundaries
July 2015
Regulation 426 - Side and rear fence height
Regulation 427 - Fences on street alignments
Regulation 431 - construction of a mast pole etc
July 2015
Submission Form:
Please provide reasons for this request and supporting information:
The personal information requested on this form is being collected by Council for the
purpose of evaluating an application. This information will be used solely by Council
for that primary or directly related purpose. The applicant understands that the
personal information provided is for the purpose of evaluating an application and that
they may apply to Council for access to and/or amendment of the information.
July 2015
Application to Council for approval to vary the Building
Regulations under part 4 of the Building Regulations 2006
Adjoining Owner Comment Form
Re: Subject property:
I (we),
Owner(s) of the property at:
Telephone:
Hereby state that I (we) do/do not object to the construction of a:
(description)
In accordance with the drawings shown to me (us) by the applicant,
Being:
Drawing’s Reference No:
Dated:
I (we) understand that the proposal does not comply with minimum siting
provisions of the building regulations in that:
As required by the current building regulations.
Other comments (if any):
By signing this statement, I (we) acknowledge that Council has no obligation to
consider the present application, nor my (our) comments, as a precedent for
assessing any future applications of this nature, anywhere in the Municipality. I
(we) understand my (our comments are only to be used as a reference to assist in
the process of making a determination on the relevant siting.
Signature:
Date:
Signature:
Date:
The personal information requested on this form is being collected by Council for the purpose of
evaluating an application. This information will be used solely by Council for that primary or directly
related purpose. The applicant understands that the personal information provided is for the purpose
of evaluating an application and that they may apply to Council for access to and/or amendment of
the information.
July 2015
Application to Council for approval to vary the Building
Regulations under part 4 of the Building Regulations 2006
Adjoining Owner Comment Form
Re: Subject property:
I (we),
Owner(s) of the property at:
Telephone:
Hereby state that I (we) do/do not object to the construction of a:
(description)
In accordance with the drawings shown to me (us) by the applicant,
Being:
Drawing’s Reference No:
Dated:
I (we) understand that the proposal does not comply with minimum siting
provisions of the building regulations in that:
As required by the current building regulations.
Other comments (if any):
By signing this statement, I (we) acknowledge that Council has no obligation to
consider the present application, nor my (our) comments, as a precedent for
assessing any future applications of this nature, anywhere in the Municipality. I
(we) understand my (our comments are only to be used as a reference to assist in
the process of making a determination on the relevant siting.
Signature:
Date:
Signature:
Date:
The personal information requested on this form is being collected by Council for the purpose of
evaluating an application. This information will be used solely by Council for that primary or directly
related purpose. The applicant understands that the personal information provided is for the purpose
of evaluating an application and that they may apply to Council for access to and/or amendment of
the information.
July 2015