Application for an engineering approval

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BC2260
Application for an engineering approval
(Public drainage, water, parks and road works)
Development engineering
Office use only
Location of works (closest service centre): (tick appropriately)
o Orewa o Takapuna o Henderson o Manukau o Papakura o Pukekohe
Reciept number:
o Central
Date:
Consent number:
Project details:
Street address: (for projects that do not have a street address, state the nearest
street intersection and the distance and direction from that intersection)
Legal description: (state legal description at the date of application and, if the land is proposed to be subdivided, include details of
relevant lot numbers & subdivision consent)
Lot no: Deposited plan DP:
Parcel:
Expected start date: Expected finish date:
Brief description of works: (e.g. public stormwater extension)
Proposed assets:
Length of pipe (m)
Pipe diameters (m)
Number of manholes
Others
Wastewater
Stormwater
Watermain
Roading
Length (m)
Widths (m)
Total area
(m2)
Parks
Number of
parks
Areas (m2)
Total area
(m2)
Application for an engineering approval
Page 1 of 4
Owner/Applicant: (mandatory)
Agent:
(only required if application is made on behalf of the owner)
Name of owner: (Include preferred form of address,
e.g. Mr, Miss, Mrs, Ms, Dr, if an individual)
Name of agent: (Include preferred form of address,
e.g. Mr, Miss, Mrs, Ms, Dr, if an individual)
Company name: (If applying on behalf of a company, please
write full company name. Please also refer to the note below)
Contact Person: (Must have NZ address)
Postal address:
Postal address:
Street address: (for courier)
Street address: (for courier)
Telephone no: (home)
Telephone no: (home)
Telephone no: (work)
Telephone no: (work)
Telephone no: (mobile)
Telephone no: (mobile)
Facsimile no:
Facsimile no:
Email address:
Email address:
Evidence of ownership: (copy of certificate of title, lease,
agreement for sale & purchase or other document showing full
name of legal owner(s) of the property should be attached)
Relationship to owner: (include copy of the authorisation
from the owner to make the application on the owner’s behalf)
Signature of applicant:
Print name:
Preferred method of communication:
Signature of agent:
Print name:
Preferred method of communication:
Note: It is the applicant who is liable for the payment of any and all processing fees. A trust will not be accepted as an applicant.
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.
Application for an engineering approval
Page 2 of 4
Chartered professional engineer, registered engineering associate or registered professional surveyor
Full name: Registration no:
Company name:
Street address:
Postal address: (if different from above)
Telephone no: (work)
(home)
(mobile)
Email address:
Note: The applicant will be sent a copy of any letters to an agent or consultant should their application need to be placed on-hold.
Acceptance of responsibility
I declare the following (please tick):
oI am a chartered professional engineer / registered engineering associate / registered professional surveyor (delete as necessary).
oI am familiar with the site and the design as shown on the application plans.
oI have physically located the drains and confirmed levels.
oI am aware of Auckland Council and Watercare standards for engineering works, and confirm that the design is in accordance with these standards.
oI 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.
oI 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.
oI 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:
These works are required as part of the following related application(s)
Subdivision (including cross-lease and unit title) consent number
If a subdivision, state the number of units or lots that will be created and attach a copy of consent
Building consent number
Other
Site constraints (Please tick those relevant):
oWork within the road reserve. o
Work within 2m of buildings or structures.
oNeighbouring properties (including those owned by council). o
Work near other services.
oCultural heritage significance of the development site. o
Work within 10m of Watercare Services Limited bulk main network .
oWork near or under the drip line and/or root zone of any tree or near any street tree.
Application for an engineering approval
Page 3 of 4
Information supplied:
The application must include the following items:
oThree sets of plans including an A3 set, named, dated and uniquely numbered. Digital PDF files should also be included.
oRelevant engineering standard details.
oCatchment plans (where appropriate, eg drainage, watermains).
oAny relevant correspondence between the council, Watercare Services Limited and Auckland Transport and the applicant or their agent, regarding this work.
oDeposit (refer to ‘Fees and charges’ brochure, or online at www.aucklandcouncil.govt.nz)
oSketch of proposed works on council’s service plans.
oSite photographs (for design context).
oSupporting calculations.
oPermission from affected public and private land owners for work on their land.
oDetails of tree protection, arborist report or tree consent.
oDetails of other services.
oOther approvals granted.
Declaration
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 signature (if applicable):
Signature:
Full name (print): Date:
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.
Signature: Date:
Auckland Council
Private Bag 92300
Auckland 1142
Phone: 09 301 0101
Application for an engineering approval
Page 4 of 4
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