Application for an engineering approval (minor)
(Public drainage, water and road works)
Development engineering
Office use only
Relevant district plan section
Application no(s):
Auckland Central Area
Auckland Gulf Islands
Auckland Isthmus
Franklin
Manukau
North Shore
Receipt date:
Papakura
Rodney
Waitākere
Deposit paid:
If you fail to complete this form and provide the necessary information,
including the deposit fee, your application may not be accepted for processing.
1. Site location details:
Site(s) to which this application relates is described as:
No:
Street:
Suburb:
Legal description(s)
2. General application details:
This application is for (tick all the boxes necessary to cover the proposal):
Wastewater
Watermain
Roading
Type of minor works
Buildover public stormwater pipe
Activities over a public stormwater pipe or manhole
Excavation likely to cause damage
Changing cover over pipe likely to cause damage
Affecting stormwater inlet/outlet that may detrimentally affect the stormwater network
Point load over public stormwater pipe likely to cause damage
Other
Length of pipe (m)
Pipe diameters (m)
Number of manholes
Others
Wastewater
Stormwater
Watermain
Roading
Length (m)
Application for engineering approval
Widths (m)
Total area (m2)
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These works are required as part of the following related application(s)
Subdivision Consent number
Building Consent number
Engineering consent number
3. Applicant/Owner details (All invoices will be made out to and sent to the applicant unless otherwise
stated in (Section 6.):
Applicant’s full name
(The name of the consent holder who will be responsible for the consent and any associated costs unless otherwise stated in Section 6)
Last Name:
First name(s):
Last Name:
First name(s):
or
Company/Trust/Organisation:
Contact person/All trustee names:
Physical address:
Postcode:
Postal address: (If different from above)
Postcode:
Phone (day):
Mobile:
Email:
Please tick if email preferred contact
Note: It is the applicant who is liable for the payment of any and all processing fees. A copy of the trust deed shall be
provided. In the case of an unregistered company, please provide the name of a natural person. In the case of a
registered company, the director’s name and signature are required. Proof of identity, e.g. driver’s licence or passport
may be required prior to acceptance of this application. By providing email contact details, you consent to being
contacted by Auckland Council or our agents for the purpose of customer satisfaction or other research
4. Agent’s or consultant’s details All invoices will be made out to and sent to the applicant
unless otherwise stated in Section 6.):
Company:
Contact:
Postal address:
Postcode:
Phone (day):
Email:
Application for engineering approval
Mobile:
Please tick if email preferred contact
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5. Chartered professional engineer, registered engineering associate or registered professional
surveyor
Company:
Contact:
Postal address:
Postcode:
Phone (day):
Mobile:
Email:
Please tick if email preferred contact
Acceptance of responsibility
I declare the following (please tick):
I am a chartered professional engineer / registered engineering associate / registered professional surveyor (delete as necessary).
I am familiar with the site and the design as shown on the application plans.
I have physically located the drains and confirmed levels.
I am aware of Auckland Council, Auckland transport and Watercare standards for engineering works, and confirm that the design
is in accordance with these standards.
I accept responsibility for taking all reasonable steps to ensure that the work is carried out to the relevant standards in
accordance with the approved plans and conditions.
I will provide, upon completion of these works, the documents as specified by Auckland Council and a certification of materials,
methods and construction details used, the tests which were carried out on these works, and a certified “As built” plan.
I shall arrange and attend a pre-construction meeting with the council’s development engineer prior to the commencement of
works and shall attend the necessary site meetings.
Signature:
Full name (print):
Date:
Site constraints (Please tick those relevant):
Work within the road reserve.
Work within 2m of buildings or structures.
Neighbouring properties (including those owned by council).
Work near other services.
Cultural heritage significance of the development site.
Work within 10m of Watercare Services Limited bulk main network .
Work near or under the drip line and/or root zone of any tree or near any street tree.
Application for engineering approval
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6. Alternative addresses for correspondence and payee of invoices
All correspondence (excluding invoices) sent to:
Applicant
Agent/Consultant
Other (name and address)
Agent/Consultant
Other (name and address)
Name:
Address:
Postcode:
All invoices made out to and sent to:
Applicant
Name:
Address:
Postcode:
7. Signature of the applicant(s) or agent
Applicant’s signature:
By signing this section I (print name)
understand the ongoing requirement to have
a chartered professional engineer, registered engineering associate or registered professional surveyor oversee the construction phase
in order to inspect and certify works, and accept that “as built” documentation will need to be provided at the completion of the
work. I also accept that I am responsible for all fees incurred.
Applicant’s signature:Date:
Declaration for the agent authorised to sign on behalf of the applicant
All the above information is, to the best of my knowledge, true and correct. I understand that all plans, documentation and reports
submitted as part of an application are required to be kept available for public record; therefore the public may view this application,
once submitted.
Agent’s full name:
Agent’s signature:Date:
Important privacy information
The personal information that you provide in this form will be held and protected by Auckland Council in accordance with our privacy
policy (available at aucklandcouncil.govt.nz/privacy and at our libraries and service centres) and with the Privacy Act 1993. Our privacy
policy explains how we may use and share your personal information in relation to any interaction you have with the council, and how
you can access and correct that information. We recommend you familiarise yourself with this policy.
Auckland Council, Private Bag 92300, Auckland 1142
Phone: 09 301 0101
Application for engineering approval
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