BUILD ON FLOOD PRONE LAND OR
LAND LIABLE TO OVERLAND FLOW
APPLICATION FOR CONSENT
Application Form: BFLA01
Purpose
This application form is for the construction of a building / structure or works that requires a building permit, on land that is
designated as flood prone by the Waterway Management Authority, Melbourne Water and/or land that is liable to overland
flow associated with Council’s stormwater drainage network. The form is in accordance with section 802 and section 806
of the Building Regulations 2006.
Applicant Details
Applicant Type (Please tick one):
Property Owner 
Builder 
Other  _______________
Form Type (Please tick one):



Application to build on Flood Prone Land
Application to build on Land Liable to Overland Flow
Both of the above
Name: _________________________________________________________________________________
Address: __________________________________________________________
Phone number: BH: _____________________
Postcode: ___________
Mob/AH:_____________________
Signature: ____________________________________ Date: _____/_____/_______
Building / Structure / Work Details
Address of Works: ________________________________________________________________________________
Brief Description of Building / Structure / Works:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Applicant Checklist
Please ensure that the following is attached to this application and levels are to the Australian Height Datum (AHD):

Plan of works – Must be clear, illustrating the extent and scope of works, with measurements, and must have
sufficient detail to determine the exact location and the impact of the proposed works

Elevations – Must be clear, showing floor levels of any structures and spot levels through the site.
Payment Details (Internal Use Only)
Receipt Number: _________________
Date Paid: _____ / _____ / ________
ACCOUNT NO: (22331.1070)
……………………………………………………………………………………………………………………………………………………………………………
Cashier Use
RC: BFL
Payment Type: Cash / Cheque / Eftpos
Receipt Number: _________________
Amount:
15/67756
$250.65
Page Number 1