SOLID WASTE MANAGEMENT DEPARTMENT CIVIC CENTRE 12 HERTZOG BOULEVARD PO BOX 655 CAPE TOWN 8000 APPLICATION FOR APPROVAL OF BUILDING WASTE GENERATORS INTEGRATED WASTE MANAGEMENT PLAN SUBMISSION OF DEMOLITION/DEVELOPMENT/BUILDING PLANS When plans are submitted to the City for its approval in terms of the National Building Regulations and Building Standards Act, 1977(Act No. 107 of 1977), the person submitting same must submit simultaneously therewith an Integrated Waste Management Plan for approval WHERE APPLICABLE, PROVISION OF THE FOLLOWING INFORMATION IS COMPULSARY: 1. Property Information 2. Owner Details 3. Owner Contact Details And where applicable 4. Authorised Proxy Details 5. Authorised Proxy Contact Details 6. Copy of Proxy Reference Number:………………………….............. 1. PROPERTY INFORMATION Erf No.: ………………... Erf Physical Address: For Office Purposes Street name and number………………………………………………….. Received Verified Y Y N N Suburb: …………………………………………………………………………….. 2. OWNER DETAILS Name of Owner: ………………………………………………………………………………………………………… Municipal Account No. : ………………... OR Business Partner No.: …………..……….. Owner Physical Address: ………………………………………………………………………………………….. …………..……………………………………………CODE:…………………………. Owner Postal Address: …………………………………………………………………………………………….. Page 1 For Office Purposes Received Verified Y Y N N …………………………………………………………CODE: ………………………. Home/Business Tel No: ……………………………… Fax No: ………………………………………… Tick preferred means of communication: Email Post Fax 3. CONTACT DETAILS OF MANDATED PROXY Full name of person signing this form and authorised to represent the Owner: ………………………………………………………………………………………………………………………………….. Identity No: For Office Purposes Received Verified Y Y N N ………………………………………………………………………………………………………… Contact Tel No: ………………………………. Cell No: ……………………………………………………… Contact Email: ………………………………………………………………………………………………………….. 3. INTEGRATED WASTE MANAGEMENT PLAN For Office Purposes Provide details: a) on provision made for minimisation and recycling of the building waste: Received Verified Y Y N N ………………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………… b) on provision made to store the waste on the property: ………………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………… c) on provision made for collection and disposal of contaminated building waste. Also provide detail of Accredited Service Provider (Company/Business Name, Physical Address, Responsible person, Contact details): ………………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………… Page 2 d) on provision made for collection and disposal of building waste. Also provide detail of Accredited Service Provider (Company/Business Name, Physical Address, Responsible person, Contact details): ………………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………… e) on permit obtained, where applicable, to store any building waste on the City’s property. Attach a copy to this document: ………………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………… 4. CONFIRMATION BY OWNER/AUTHORISED PROXY I, ……………………………………………………………, property owner/authorised proxy, hereby declare that all the information provided in this application is valid and correct. I shall only remove and dispose of building waste at a licenced crushing plant or landfill site or any other licenced building waste disposal facility. I shall provide the building control officer with proof of weighbridge certificates, that the full mass of the building rubble was disposed at a licenced crushing plant or landfill site or any other licenced building waste disposal facility for that category of waste, prior to an occupancy certificate or any final approvals being granted. ………………………………………………………………. ……………………………………………………………………… Signature Date TO BE SUBMITTED ALONG WITH BUILDING PLANS FOR APPRVAL CERTIFIED COPIES OF ALL SUPPORTING DOCUMENTS TO BE PROVIDED WITH THIS APPLICATION Page 3