FORM 3
PROTECTION WORK NOTICE
Building Act 1993
Building Regulations 2006
Regulations 602(2), 602(3)
TO .......................................................................................……………............................................................................
Adjoining Owner .....................................…………..............................................................................
Postal Address .....................................................................…………........... Postcode ..................
Relevant Building Surveyor
Postal Address .....................................................................…………........... Postcode ..................
Contact Person ................................................………….............................. Telephone ..............…
Email .......................................................................................………….............................................
FROM
Owner/Agent ..........................................................................……...........................………................
Postal Address .....................................................................…………........... Postcode ..................
Contact Person ................................................………….....................…....... Telephone .................
Email .......................................................................................………….............................................
In accordance with section 84 of the Building Act 1993, I give notice of my intention to carry
out the following building work on my land and request your agreement to the proposed
protection work.
DETAILS OF PROPOSED BUILDING WORK ...............................................................…………….......................
................................................................................................…………...........................................…
PROPERTY DETAILS
No ............ St/Road ..................…………............................................ Suburb .................................
Lot /s.....……....... LP/PS .....….......Vol. .............. Folio. ........... Crown Allot ..........Section …...…....
Municipal District: Monash City Council
ADJOINING PROPERTY DETAILS
No ............ St/Road ..................…………............................................ Suburb ................................
Lot /s.....……....... LP/PS .....….......Vol. .............. Folio. ........... Crown Allot ..........Section ……......
Municipal District: Monash City Council
DETAILS OF PROPOSED PROTECTION WORK AND PROGRAM
Nature, location, time and duration of protection works: ........................................................
..................................................................................................................……........…......................
..................................................................................................................……........…......................
Signature .........………......…………......................  Owner  Agent
NOTE:
Date ........................
Under section 85 of the Building Act 1993, the adjoining owner must respond to a notice under Section 84
of that Act by giving to the owner within 14 days a notice under section 85 of that Act (a)
agreeing to the proposed protection work; or
(b)
disagreeing with the proposed protection work; or
requiring more information.
Failure to respond will be taken as agreement to the proposed protection work.
In the case of (b) and (c) above, a copy of the notice under Section 85 of that Act must also be given to the
relevant building surveyor. (See Form 4).
293 Springvale Road (PO Box 1) Glen Waverley VIC 3150 Web www.monash.vic.gov.au Email mail@monash.vic.gov.au
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BLD0303 – 10/01/00 – LAST UPDATE 7/7/15
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BLD0303 – 10/01/00 – LAST UPDATE 7/7/15